What If My Hemorrhoids Do Not Respond to Conservative Treatment?

Most people find relief for their hemorrhoids by acting to reduce constipation and other risk factors. When a patient presents with hemorrhoids, we often first prescribe a diet high in fiber, with plenty of fruits and vegetables. Other lifestyle changes and stool softeners may also be a part of our prescribed conservative treatment.

Often, this allows inflamed hemorrhoids to heal, and the patient has symptom relief within a few days to a week. However, this is not effective for every patient. Not responding to this conservative treatment does not mean you need an invasive procedure, though. There are several options we can discuss to ensure you get the Los Angeles hemorrhoid treatment that best fits your unique case.

There May Be An In-Office Treatment That Can Help

For many people who have symptomatic hemorrhoids or hemorrhoids that don’t respond to conservative treatments, we may be able to address their symptoms with relatively painless office treatments.The best treatment depends on your unique condition.

Some options may include:

  • Rubber Banding: Sometimes called rubber band ligation, this procedure is commonly performed on prolapsing hemorrhoids. The procedure is simple, with few risks. It is performed in your doctor’s office in just a few minutes. Your physician uses a special technique to put a rubber band at the base of the hemorrhoid, cutting off the blood flow to the inflamed tissue. Without blood flow, the hemorrhoid will fall off in about a week.
  • Sclerotherapy:Sclerotherapy injections are often effective for smaller symptomatic hemorrhoids. During this in-office treatment, your doctor will inject a special medicine into the mucous membranes beside the inflamed hemorrhoidal tissue. This medicine makes the blood vessels feeding the tissue shrink, leading the hemorrhoid itself to shrink.
  • Photocoagulation: When hemorrhoids are actively bleeding, your doctor may opt to use a special photocoagulation device to stop the bleeding. This procedure is performed in the doctor’s office and takes only a few minutes. Your doctor will use a device that shoots a focused infrared light at the hemorrhoid, affecting the blood vessels and stopping the bleeding.

Less Invasive Surgical Procedures May Be a Good Choice

Sometimes, it comes down to needing more treatment than is possible in your doctor’s office. In some cases, patients need a hemorrhoid operation. Surgery is sometimes the best option if you have large or particularly bothersome hemorrhoids, hemorrhoids that returned after treatment, or other complications.

Just because you need surgery does not mean the best option is a traditional open hemorrhoidectomy, though. Newer, less invasive procedures can be just as effective for many patients without the intense postoperative pain or extended recovery of a traditional operation.

One of the most common procedures we recommend is Procedure for Prolapse and Hemorrhoids, or PPH. Sometimes known as a stapled hemorrhoidectomy, this procedure uses a special circular stapling device to pull the inflamed tissue back into place and hold it there with staples. It takes only about 30 minutes and is performed as an outpatient surgery.  Another outpatient surgical option may be Transanal Hemorrhoid Dearterialization (THD) which uses a specialized doppler system to identify blood vessels feeding the hemorrhoids and allow your doctor to ligate them without excising any tissue.

Traditional Surgery Is Still the Best Option for Some

There are some cases where even PPH and other less invasive procedures are contraindicated. Even though these modern procedures have many advantages over a traditional operation when it comes to bouncing back from surgery, there are still conditions where the best treatment is still surgical removal of the inflamed hemorrhoidal tissue. If one of these surgical procedures is not appropriate for your condition, you may need an open hemorrhoidectomy.

Doctors have been performing this traditional surgery for hemorrhoids for decades, and it is considered a relatively safe and routine operation as long as it is performed by an experienced surgeon. Surgical treatment of hemorrhoids is the best way to prevent recurrence and the best treatment for particularly complicated cases. However, this surgery usually leads to significant postoperative pain.

Often, patients experience much more pain from the surgery than they did from the hemorrhoids. This pain can last several days, and typically fades within a week to ten days. Some people require two weeks or more to recover from surgery and return to work.

Talk to Your Doctor About Your Options

The best way to understand your options if your hemorrhoids have not responded to conservative treatment is to contact a hemorrhoid specialist. At Los Angeles Colon & Rectal Surgical Associates, our proctologists and colorectal surgeons utilize a number of cutting edge treatments to help stop the itching, burning, and pain of hemorrhoids. You can schedule a confidential consultation by calling (310)273-2310. We can help you find the best treatment for your condition.