Hemorrhoid treatment

Hemorrhoid treatment has evolved significantly: the classic surgical approach can be replaced today, in many cases, with minimally invasive treatments, less painful and with little or no hospitalisation — the steam method, foam sclerotherapy and cryotherapy. The right method is established at the specialist consultation, depending on the type of hemorrhoids (internal or external), their size and the stage of the hemorrhoidal disease.

Hemorrhoid treatment at a glance

• Modern methods: the steam method, foam sclerotherapy, cryotherapy
• Type of procedures: minimally invasive, short (from a few minutes to ~10 minutes)
• Hospitalisation: none (sclerotherapy, cryotherapy) or one night (the steam method)
• Anaesthesia: from none (sclerotherapy) to local or spinal, depending on the method
• Recovery: immediate or within 48 hours, depending on the method
• First step: the specialist consultation — essential for a correct diagnosis

What are hemorrhoids?

Hemorrhoids are varicose dilations of the hemorrhoidal veins located in the upper and middle region of the anal canal — one of the most widespread but also most neglected conditions: present in about 8 in 10 people, affecting men and women equally. The disease often goes unnoticed, because it does not always produce changes in one’s state of health.

Hemorrhoids can be internal (formed from the upper rectal venous plexus) or external (from the lower rectal venous plexus), and their course can be chronic — with itching, a foreign-body sensation and bleeding on defecation, in 4 stages of severity — or acute (hemorrhoidal thrombosis), with strong pain, swelling and redness. Full details about classification, symptoms and causes on the Hemorrhoids page.

Why is the specialist consultation important?

Seeing a specialist doctor is very important from the very first signs of hemorrhoids, for two reasons. First, the disease can easily be confused with more serious conditions — secondary hemorrhoids can mask liver cirrhosis, a pelvic tumour, rectal or colon cancer. Second, left untreated, hemorrhoidal disease can have a severe impact on the body: repeated bleeding leads to anaemia, and the prolapse and strangulation of hemorrhoids are situations of great severity, requiring specialist intervention.

The symptoms that require a consultation: bright red bleeding on defecation, pain, persistent itching, a feeling of heaviness or of a foreign body in the anal area, lumps, discomfort when sitting.

What modern methods exist for treating hemorrhoids?

The steam method

A short, minimally invasive intervention — about 10 minutes — that destroys the hemorrhoidal formations by coagulating the tissue with steam, without burning it. It successfully replaces classic surgery for large hemorrhoids, internal or external, with higher-quality scarring, a much lower risk of anal stenosis and the sphincter’s functionality preserved. It usually requires an overnight stay and 48 hours of rest at home.

Foam sclerotherapy

The injection of a sclerosing agent that blocks the blood flow feeding the hemorrhoids. It is statistically the preferred method for grade 1 hemorrhoids and works very well for grade 2 as well: studies show that 88% of patients have no more symptoms after a single session, and 97% after two. No anaesthesia, no hospitalisation, with immediate resumption of activities.

Cryotherapy

“Drying out” the hemorrhoids by closing the veins that feed them, with a probe cooled to about −90 °C. It is done on an outpatient basis, under local anaesthesia, for internal and external formations; the directly applied cold also soothes pain, inflammation and itching. Complete treatment usually requires 2–3 sessions, one month apart.

Which method is the most suitable?

The general rule is simple: size and stage dictate the method.

• small hemorrhoids (grade 1–2): foam sclerotherapy — fast, without anaesthesia, with excellent success rates
• internal and external hemorrhoids of medium size: cryotherapy — outpatient, with an immediate soothing effect
• large hemorrhoids: the steam method — a single intervention, with a definitive result and recovery in 48 hours
• advanced or complicated cases: may still require classic surgical treatment

The final recommendation belongs to the specialist, following the consultation — the methods can often also be combined, depending on the number and type of formations.

What can you do alongside the treatment?

Whatever the chosen method, the general recommendations after the procedure include: a balanced, fibre-rich diet, fighting constipation through natural means (avoiding laxatives), chamomile sitz baths and, at the doctor’s recommendation, venotonic treatment, suppositories, anti-inflammatories or creams. Fighting the risk factors — sedentariness, prolonged sitting, a low-fibre diet — is the essential rule for avoiding both the disease and its recurrences.

Frequently asked questions

Can hemorrhoids be treated without surgery?

Yes, in many cases. The minimally invasive methods — steam, sclerotherapy, cryotherapy — replace classic surgery, with much less pain and a fast recovery. Surgery remains reserved for advanced or complicated cases.

Does hemorrhoid treatment hurt?

Discomfort and post-operative pain are much lower than with traditional surgery. Sclerotherapy needs no anaesthesia at all, cryotherapy is done with local anaesthesia (and the cold soothes the pain), and the steam method uses a long-acting anaesthetic that reduces post-operative pain.

Does bleeding on defecation always mean hemorrhoids?

Not necessarily — and this is exactly why the specialist consultation is mandatory. Bleeding can also have more serious causes, which must be ruled out before any hemorrhoid treatment.

Can hemorrhoids come back after treatment?

Yes, especially if the risk factors persist: frequent constipation or diarrhoea, sedentariness, prolonged sitting, a low-fibre diet, heavy lifting. A balanced lifestyle significantly prolongs the result of any method.

How soon can I return to work?

After sclerotherapy and cryotherapy — immediately, the same day. After the steam method — usually after the 48 hours of rest at home.