Should You Consider Surgery for Recurring Hemorrhoids?

Q: Should You Consider Surgery for Recurring Hemorrhoids?

Hello： In response to your questions. <br>1. <br>If the thrombosed hemorrhoid is not too large and the pain is not severe, then it can be managed similarly to the previous thrombectomy you had. <br>2. <br>The medication "Hemorrhoid Ointment" is also used in our clinic, and it can

Should surgery be performed?

Hello, I had thrombosed hemorrhoids in August last year.
At that time, the doctor performed the surgery without anesthesia and cut it open to remove it.
However, now, six months later, it has recurred.
I have a small lump about 1 cm near the anus, which is somewhat painful.
It feels better after soaking in warm water.
The doctor directly suggested surgery for a permanent solution and prescribed me "Hemorrhoid Ointment" to apply.
Is this ointment good? I read online that ointments containing anesthetic ingredients should not be used for hemorrhoids, and this one contains anesthetic components, so I'm unsure whether to use it.
Are my current symptoms severe or manageable? Do I need to have surgery immediately, or can I opt for conservative treatment? I'm concerned that surgery might lead to issues like fecal incontinence or anal atrophy.
If surgery is necessary, which type is better? Also, what should I pay attention to in my daily life? Please clarify my doubts, thank you.

Yong, 20~29 year old female. Ask Date: 2005/04/09

Dr. Ke Fangxu reply Surgery

Hello: In response to your questions.
1.
If the thrombosed hemorrhoid is not too large and the pain is not severe, then it can be managed similarly to the previous thrombectomy you had.
2.
The medication "Hemorrhoid Ointment" is also used in our clinic, and it can be prescribed after an evaluation by a physician.
The caution against using topical anesthetic ointments refers to self-purchasing and using them without medical advice, which may mask symptoms and worsen the condition.
3.
Based on your description, the symptoms do not seem severe, and conservative treatment or thrombectomy should suffice.
However, if you find it quite bothersome, surgical removal can provide a permanent solution.
Generally, consulting a colorectal surgeon will minimize the risk of complications, though you may experience pain for about a week post-surgery.
4.
In your daily routine, it is important to avoid constipation, limit spicy foods, refrain from prolonged sitting, and increase your intake of fruits and vegetables.

Reply Date: 2005/04/09

More Info

When considering surgery for recurring hemorrhoids, it's important to weigh the severity of your symptoms against the potential risks and benefits of surgical intervention. Hemorrhoids, particularly thrombosed hemorrhoids, can cause significant discomfort, pain, and complications if not managed properly. Given your history of a thrombosed hemorrhoid and the current presence of a painful lump near the anus, it seems you are experiencing a recurrence of your condition.

Your doctor has suggested surgery as a definitive solution, which is a common recommendation for recurrent or severe hemorrhoids. Surgical options can range from minimally invasive procedures, such as rubber band ligation or sclerotherapy, to more invasive surgeries like hemorrhoidectomy. The choice of procedure often depends on the size, type, and severity of the hemorrhoids, as well as the patient's overall health and preferences.

Regarding the topical medication "痔莫" (presumably a hemorrhoid ointment), it is essential to follow your doctor's advice while also being cautious about the ingredients. Many hemorrhoid creams contain local anesthetics to relieve pain, but some patients may experience side effects or allergic reactions. If you have concerns about the anesthetic component, it would be prudent to discuss this with your doctor, who can provide guidance based on your specific situation.

Your symptoms, including the painful lump and discomfort, suggest that your condition may not be mild. If the lump is causing significant pain or if you notice any bleeding, it may be wise to consider surgical intervention sooner rather than later. Delaying surgery could lead to further complications, such as increased pain, infection, or the development of more severe hemorrhoids.

In terms of lifestyle modifications, there are several strategies you can adopt to help manage your symptoms and prevent future occurrences:
1. Dietary Changes: Increase your fiber intake by consuming more fruits, vegetables, and whole grains. This can help soften stools and reduce straining during bowel movements, which is a significant contributor to hemorrhoid development.

2. Hydration: Drink plenty of water throughout the day to stay hydrated, which can also aid in preventing constipation.

3. Regular Exercise: Engage in regular physical activity to promote healthy bowel function and reduce the risk of constipation.

4. Avoid Straining: When using the bathroom, avoid straining or sitting for prolonged periods, as this can exacerbate hemorrhoid symptoms.

5. Warm Baths: Soaking in warm baths can provide relief from pain and discomfort associated with hemorrhoids.

6. Avoid Heavy Lifting: If possible, avoid heavy lifting or activities that may put pressure on the pelvic area.

Ultimately, the decision to proceed with surgery should be made in consultation with your healthcare provider, who can assess your specific condition and provide personalized recommendations. If you have concerns about potential complications from surgery, such as fecal incontinence or anal stenosis, be sure to discuss these with your doctor. They can help you understand the risks and benefits of surgery compared to conservative management options.

In conclusion, while conservative treatments may provide temporary relief, surgery may be the most effective long-term solution for recurrent hemorrhoids. It's crucial to have open communication with your healthcare provider to make an informed decision that aligns with your health needs and lifestyle.

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