Harvard Men's Health Watch

When to repair a hemorrhoid

Q. I have suffered with bleeding hemorrhoids for many years. Changing my diet, adding fiber, and having sitz baths have not improved the problem. My doctor suggested surgery. Is this risky?

A. Hemorrhoids are swollen veins around the anal canal. Internal hemorrhoids are located inside the anus but can sometimes protrude to the anal opening; bleeding is the major problem with these. External hemorrhoids are located at the rim of the anus; these can also cause bleeding as well as itching and pain.

If you aren't able to control hemorrhoid symptoms to your satisfaction with lifestyle changes or topical therapies (creams, ointments, or suppositories), then you could consider surgical repair. One procedure is called rubber band ligation (RBL), in which a small band is placed around an internal hemorrhoid to cut off the blood supply. RBL is usually effective at least half of the time, and repeated ligations improve the success rate. Ligation causes minor pain for most people but no long-term side effects.

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