Intestinal health: If you have hemorrhoids, can you just cut them off?

Principles of hemorrhoid treatment:

First, hemorrhoids without symptoms do not require treatment, and only hemorrhoids with symptoms should be considered for treatment.

Second, the principle of treating hemorrhoids is conservative treatment. Only when conservative treatment or outpatient device treatment in the hospital, such as rubber band ligation or drug injection treatment, is ineffective, and the hemorrhoid symptoms are so severe that they affect daily life and health, such as frequent bleeding, severe hemorrhoid prolapse, and even anemia, surgical treatment should be considered.

As the saying goes, nine out of ten people suffer from hemorrhoids. Hemorrhoids are divided into different grades according to their severity, and the treatment methods vary accordingly.

Taking internal hemorrhoids as an example, internal hemorrhoids are divided into four degrees:

First-degree internal hemorrhoids usually occur after improper diet, such as eating chili peppers, drinking alcohol or constipation. Patients may feel mild discomfort, pain, bleeding or itching around the anus. At this stage, the hemorrhoids themselves will not protrude from the anus. For first-degree internal hemorrhoids, conservative treatment is usually recommended.

Second-degree internal hemorrhoids present with more obvious symptoms, including blood in the stool, local pain or itching in the anus during bowel movements. In this case, the hemorrhoids may temporarily protrude from the anus after defecation, but they will retract on their own after the defecation is over. This prolapse and retraction of the hemorrhoids is a typical manifestation of second-degree internal hemorrhoids.

Third degree internal hemorrhoids are caused by the hemorrhoids protruding out of the anus every time a bowel movement occurs, and the degree of protrusion is so severe that the hemorrhoids cannot retract on their own. After a bowel movement, the patient needs to manually push the hemorrhoids back into the anus, usually with toilet paper under it, which is a clear sign of third degree internal hemorrhoids.

Fourth-degree internal hemorrhoids are like a flower blooming outside. At this time, we figuratively call it a plum blossom. It is a very typical plum blossom-like hemorrhoid. After it prolapses, it cannot be put back. This is the fourth degree.

Whether surgery is performed is closely related to the grade of hemorrhoids.

First-degree hemorrhoids do not require surgical treatment, and second-degree hemorrhoids are mainly treated conservatively if the bleeding is not serious. There are many methods of conservative treatment, such as applying hemorrhoid cream, inserting hemorrhoid suppositories, taking intravenous active drugs, or using outpatient device therapy, etc. Its treatment efficiency can reach more than 70%-80%. For third-degree or fourth-degree internal hemorrhoids, if conservative treatment is not effective and affects work and quality of life, it is recommended to follow the doctor's advice and actively undergo surgical treatment.

In addition to internal hemorrhoids, there are also external hemorrhoids. If it is an external hemorrhoid, especially a thrombosed external hemorrhoid, the pain is very severe and unforgettable. At this time, surgery is also required. The surgery is actually very simple. Just peel off the thrombosed external hemorrhoid. In addition, some inflammatory external hemorrhoids are very painful and can also be operated on.

What are the consequences if you need surgery but don't have it?

It will greatly interfere with the patient's daily life. Imagine that a sneeze is enough to make the hemorrhoids prolapse. This situation is not only extremely uncomfortable, but also an unspeakable private pain. And it may be accompanied by persistent pain and itching, causing restlessness, and the pain may be aggravated by prolonged friction. In some cases, the hemorrhoids may become incarcerated, causing edema or even necrosis, resulting in severe pain.

Moreover, hemorrhoidal bleeding is also a symptom that cannot be ignored. Some patients may not have prolapsed hemorrhoids, but the amount of bleeding is quite large. Even for second-degree hemorrhoids, if left untreated, continuous bleeding may cause a significant drop in hemoglobin levels, and in severe cases, shock may even occur due to acute blood loss.

The treatment of hemorrhoids is not a simple "one size fits all" approach, but needs to be determined based on symptoms and severity. Conservative treatment is the first choice, but when symptoms are severe and affect the quality of life, surgical treatment is necessary. It is important that patients seek the advice of a professional doctor and develop a treatment plan that suits them.

Author: Dr. Chrysanthemum Lin Guole Team

Reviewer: Wang Qiang, deputy chief physician of the Department of Gastroenterology, Peking Union Medical College Hospital

Produced by: China Association for Science and Technology Department of Science Popularization

Producer: China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.