Persistent External Hemorrhoids: When Is Surgery the Only Option? - Surgery

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Persistent external hemorrhoids can be a frustrating and uncomfortable condition, especially when conservative treatments such as topical ointments have not yielded satisfactory results over an extended period. In your case, it seems that you have been using a topical medication for nearly two years without any noticeable improvement, and you are concerned about the possibility that your hemorrhoids may have been present since infancy.

To address your question about when surgery becomes the only option for persistent external hemorrhoids, it is essential to understand the nature of hemorrhoids and the factors that influence treatment decisions.

Hemorrhoids, which are swollen veins in the rectal area, can be classified as either internal or external. External hemorrhoids are located outside the anal canal and can cause discomfort, pain, and bleeding, particularly during bowel movements. While many cases of hemorrhoids can be managed with conservative treatments, such as dietary changes, topical medications, and lifestyle modifications, there are situations where surgical intervention becomes necessary.

1. Persistent Symptoms: If you have been experiencing persistent symptoms such as pain, bleeding, or discomfort for an extended period (in your case, two years), and conservative treatments have not provided relief, it may be time to consider surgical options. Surgery is often recommended when the hemorrhoids are causing significant discomfort or when they do not respond to non-surgical treatments.

2. Size and Appearance: You mentioned that your external hemorrhoid is approximately one centimeter in size and has a dark, soft appearance. Larger hemorrhoids or those that have changed in size or color may warrant further evaluation. If the hemorrhoid is thrombosed (clotted), it can cause severe pain and may require surgical intervention to relieve the symptoms.

3. Quality of Life: If your hemorrhoids are affecting your quality of life, such as interfering with daily activities or causing anxiety, surgery may be a viable option. The decision to proceed with surgery should be based on a thorough discussion with your healthcare provider about the potential benefits and risks.

4. Underlying Conditions: Given your history of having a growth near the anal area since infancy, it is essential to have a comprehensive evaluation. While it is possible that the external hemorrhoid is a result of this growth, a healthcare professional should assess it to rule out any other conditions, such as anal warts or skin tags, which may require different treatment approaches.

5. Surgical Options: If surgery is deemed necessary, there are various techniques available, including hemorrhoidectomy (removal of the hemorrhoid) and other minimally invasive procedures. Your surgeon will discuss the most appropriate option based on your specific situation.

In conclusion, if conservative treatments have not been effective and your symptoms persist, it is reasonable to consider surgical intervention. It is crucial to have an open and honest discussion with your healthcare provider about your symptoms, treatment history, and concerns. They can provide guidance on the best course of action and help you weigh the benefits and risks of surgery. Remember, the goal is to improve your quality of life and alleviate any discomfort you may be experiencing.