Hemorrhoids are common in both men and women, and approximately 50%¹ of adults 50 years and older have hemorrhoids. Unfortunately, most victims may suffer in silence as they consider hemorrhoids a part of the aging process or are afraid to speak about it.
Sometimes, hemorrhoids do not require treatment—they clear up on their own after a few days or weeks. However, if you experience pain, discomfort, or worsening symptoms from hemorrhoids, you should seek help.
The good news is that there are various non-surgical hemorrhoid treatment options available.
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Hemorrhoids, or piles, are swollen veins in your lower rectum or anal canal, similar to “varicose” veins. Internal hemorrhoids form inside the rectum, while external hemorrhoids occur closer to the anus. Risk factors for hemorrhoids include;
Chronic constipation and diarrhea
Not enough fiber consumption
Piles are classified by the degree of prolapse, and treatment is based on which degree you are at.
1st-degree internal hemorrhoids: these internal hemorrhoids do not protrude or prolapse outside the anus.
2nd-degree hemorrhoids: at this stage, your hemorrhoids protrude outside the anal canal when your strain but reduce spontaneously.
3rd-degree hemorrhoids: the hemorrhoids protrude outside the anal canal and require manual reduction.
4th-degree hemorrhoids: the hemorrhoids are constantly prolapsed and irreducible.
A hemorrhoid diagnosis is crucial for choosing the best treatment. Diagnosis helps your medical provider understand your condition and recommend the best approach.
Here's how the diagnosis works:
Digital rectal exam: your healthcare provider inserts a gloved, lubricated finger into your rectum to feel anything unusual, like growth or swollen veins.
Anoscopy: your doctor uses a lighted tube (anoscope) to view the lining of the rectum and anus.
Sigmoidoscopy (limited colonoscopy): the healthcare provider uses a lighted tube with a camera (sigmoidoscope) to view the lower part of the colon and rectum. Procedure types include rigid sigmoidoscopy and flexible sigmoidoscopy.
The tests might be uncomfortable, but they aren't painful. Therefore, you won't require any form of anesthesia. Sometimes, your doctor may order a full colonoscopy² to check for signs of colon cancer or confirm the results of the tests above.
You can treat hemorrhoids using surgical and non-surgical treatments. However, some people have tomophobia³—a scientific term for fear of surgical procedures.
This fear stems from losing control, being in an unusual environment, pain, undergoing anesthesia, the recovery process, and fear of negative surgical results. Therefore, they prefer non-invasive ways to treat hemorrhoids.
Rubber band ligation is a cost-effective, non-surgical treatment procedure for Grade 2 or 3 internal hemorrhoids. This minimally-invasive procedure involves tying off internal hemorrhoids at the base to cut off blood flow. Moreover, rubber band ligation is an outpatient procedure, meaning you can go home after the treatment.
Before the procedure, your doctor may give you anesthesia or apply topical anesthetic to your rectum. However, typically no anesthesia is needed.
Your doctor will then carefully insert an anoscope (viewing scope) into your anus to visualize your internal hemorrhoids. Then, they will insert a small tool known as a ligator through the anoscope.
Your doctor will use the ligator to place one or two tiny rubber bands at the base of your internal hemorrhoids to stop blood flow.
The process takes a few minutes, depending on the number of hemorrhoids being banded.
The rubber bands cut off the blood supply to the internal hemorrhoids, causing them to wither and eventually fall off. Once the hemorrhoids dry up, they'll pass with bowel movements—you won't even notice.
After the procedure, you may experience the following;
Moreover, you may experience some bleeding for a few days after rubber band ligation. Contact your doctor if the bleeding doesn't stop after a few weeks.
Sclerotherapy is non-surgical procedure doctors use to treat Grade 1 or 2 hemorrhoids. Your doctor injects a chemical solution known as a sclerosant into the hemorrhoid tissue to destroy it.
The injection damages the blood vessels around hemorrhoids, limiting or preventing blood flow to the growth and causing them to shrink and eventually disappear.
Typically, sclerotherapy is most effective for treating small hemorrhoids. However, you might require several treatments to increase effectiveness, though you should experience little to no pain following this hemorrhoid treatment. Moreover, sclerotherapy may be less effective than rubber band ligation.
Some risks associated with this treatment include:
An allergic reaction to the injected solution
Infrared coagulation⁴ is an effective non-surgical treatment for Grade 1 or 2 internal hemorrhoids. The procedure utilizes an infrared light as a heat source to halt blood supply to internal hemorrhoids. As a result, the blood vessels will coagulate, causing the hemorrhoids to shrink.
As the doctor applies the infrared light, you may feel some warmth inside your rectal areas. However, this should only cause minimal discomfort. If you experience any pain during the procedure, notify your doctor.
The therapy lasts less than 10 minutes, and you can resume normal activities after the treatment. You may experience some discomfort 5-10 days after the procedure. Also, you should expect bleeding 7-10 days after infrared coagulation. However, the bleeding should light and usually stop on its own.
Also, avoid straining during bowel movements to prevent the hemorrhoids from returning.
Some risks linked to coagulation therapy include:
Considerable pain during the procedure
Infection in the anal areas.
Cryosurgery⁵ involves using an extremely cold liquid nitrogen or equipment called a cryoprobe cooled with liquid nitrogen to freeze and destroy hemorrhoids. The cryoprobe is cooled using a substance like compressed argon gas or liquid nitrogen.
Your doctor will use local anesthesia to numb the area around your anus or rectum before the procedure. They will also ligate the hemorrhoids before freezing them off. Then, the doctor will use the cryoprobe to apply liquid nitrogen to the lesions.
Cryosurgery can be more painful than other medical hemorrhoid treatments, with less patient satisfaction.
Laser hemorrhoidectomy is a relatively new procedure for treating hemorrhoids.
The laser beam will cauterize and seal off the blood vessels, stopping blood flow to the hemorrhoids and shrinking it.
Laser hemorrhoidectomy does not seem to offer any benefits over other approaches, and life-threatening complications have been demonstrated. This makes it a less desirable option at this point.
Hemorrhoids are a common condition, especially in adults 50 years and older. They may cause pain, itching, irritation, swelling, and discomfort. The good news is that you can treat hemorrhoids using non-surgical treatments like rubber band ligation, injection sclerotherapy, and infrared coagulation.
Talk to your doctor to determine the best option for you.
Yes. You can get rid of hemorrhoids through rubber band ligation, injection sclerotherapy, and infrared coagulation, all of which can be done from your doctor’s office.
It depends on the type and stage of your hemorrhoids. Your doctor will diagnose your condition and recommend the best hemorrhoid treatment.
Yes, they can, though only a few people will experience this recurrence.
Definition & facts of hemorrhoids | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Colonoscopy | National Institute of Diabetes and Digestive and Kidney Diseases
Treatment of hemorrhoids | National Institute of Diabetes and Digestive and Kidney Diseases
Medical procedures for hemorrhoids | GI Society
What is infrared coagulation (IRC) and how does it remedy hemorrhoids? | Midwest Hemorrhoid Treatment Center
Cryosurgery | NIH: National Cancer Institute
Cryo surgery | Proctocure
Infrared photocoagulation for hemorrhoids | Health Link BC
7 ways to treat hemorrhoids without surgery | Gastroenterology Consultants of San Antonio