Hemorrhoids can cause bleeding, swelling, itching, prolapse, and pain, but having these symptoms does not automatically mean that surgery is needed. Many patients improve with bowel-habit changes, treatment of constipation or diarrhea, medication, or a suitable office procedure. Surgery is generally considered when symptoms are severe, persistent, recurrent, or caused by hemorrhoids that are unlikely to respond adequately to simpler treatment.
Rectal bleeding should not be assumed to come from hemorrhoids without an assessment. Anal fissures, inflammation, polyps, and other digestive or anorectal conditions can produce similar symptoms. The correct treatment starts with confirming the diagnosis.
Patients seeking a confidential assessment can arrange a general surgery consultation in Sharjah at Emirates European Hospital.
What are hemorrhoids?
Hemorrhoidal tissue is a normal part of the anal canal. It contains blood vessels and supporting tissue that help with closure and continence. The condition commonly called hemorrhoids or piles develops when this tissue becomes enlarged, displaced, inflamed, thrombosed, or symptomatic.
Hemorrhoids are usually divided into two main types:
- Internal hemorrhoids develop inside the anal canal. They may cause bright-red bleeding, tissue that protrudes during a bowel movement, mucus, irritation, or difficulty cleaning.
- External hemorrhoids occur beneath the sensitive skin around the anal opening. They may cause swelling, discomfort, or a painful lump, especially when a blood clot forms.
Some patients have both internal and external disease. Because the two types differ in location and sensitivity, the treatment that is suitable for one may not be suitable for the other.
What symptoms can hemorrhoids cause?
Common symptoms include:
- Bright-red blood on toilet paper, on the stool, or in the toilet
- A lump or swelling at the anal opening
- Tissue that comes out during a bowel movement
- Itching, irritation, mucus, or difficulty cleaning
- Pressure or a feeling of incomplete emptying
- Pain while sitting or passing stool
- Sudden, constant pain from a thrombosed external hemorrhoid
Internal hemorrhoids often bleed without causing sharp pain. Severe pain may point to a thrombosed external hemorrhoid, an anal fissure, an abscess, or another condition. A clinical examination is important when the diagnosis is uncertain.
Emirates European Hospital also provides assessment and treatment for anorectal conditions in Sharjah, including hemorrhoids, fissures, fistulas, and other causes of anal pain or bleeding.
When should rectal bleeding be checked?
New, repeated, or unexplained rectal bleeding should be medically assessed, even when hemorrhoids seem likely. The clinician may need to consider the patient’s age, bowel habits, amount and color of blood, medications, anemia symptoms, family history, and colorectal screening history.
Seek urgent medical care for heavy or continuing bleeding, fainting, dizziness, marked weakness, black or tar-like stool, severe abdominal pain, fever, or rapidly worsening anal pain and swelling. These features are not appropriate for self-diagnosis online.
What causes hemorrhoid symptoms to worsen?
Symptoms are often associated with repeated pressure, straining, or irregular bowel movements. Contributing factors may include:
- Constipation and hard stool
- Prolonged straining during bowel movements
- Frequent diarrhea
- Spending a long time sitting on the toilet
- Pregnancy and childbirth
- Excess body weight
- Heavy lifting in some patients
- Low-fiber eating patterns
- Age-related weakening of supporting tissue
Correcting a contributing factor is important even when a procedure is performed. Surgery can treat enlarged or prolapsing tissue, but it does not remove every future cause of constipation, straining, or irregular stool.
How are hemorrhoids diagnosed?
A consultation usually starts with a private discussion of bleeding, pain, prolapse, bowel habits, duration of symptoms, previous treatment, medications, and relevant personal or family history. Tell the surgeon about anticoagulants, antiplatelet medicines, pregnancy, inflammatory bowel disease, anemia, and previous colorectal problems.
The examination may include visual inspection, a gentle digital rectal examination, and anoscopy to view the anal canal. Further testing is not required for every patient. However, sigmoidoscopy, colonoscopy, laboratory testing, or another investigation may be recommended when the bleeding pattern, age, risk factors, examination, or screening history suggests that another cause should be excluded.
A surgical consultation does not mean that an operation has already been decided. It is the step used to identify the cause and compare conservative, procedural, and surgical options.
How are internal hemorrhoids graded?
Internal hemorrhoids are often classified according to prolapse:
- Grade I: enlarged internal hemorrhoids without prolapse outside the anus
- Grade II: prolapse during straining but return inside on their own
- Grade III: prolapse and usually need to be pushed back manually
- Grade IV: remain prolapsed and cannot be pushed back
Grade helps guide treatment, but it is not the only deciding factor. Bleeding, pain, external disease, hygiene problems, recurrence, the effect on daily life, previous treatment, and the patient’s health also matter.
Can hemorrhoids improve without surgery?
Yes. Many mild or moderate cases improve without an operation. Initial management may include:
- Increasing dietary fiber gradually
- Drinking an appropriate amount of fluid unless medically restricted
- Treating constipation or persistent diarrhea
- Avoiding prolonged straining and long toilet sessions
- Responding to the natural urge to pass stool
- Regular physical activity when appropriate
- Warm sitz baths for temporary comfort
- Short-term topical or oral medication when recommended
Over-the-counter creams may temporarily reduce irritation, but they do not correct significant prolapse or every cause of anal symptoms. Prolonged or repeated use of medicated creams should be discussed with a clinician, particularly if symptoms continue.
If symptoms are mild, improving bowel consistency and reducing strain may be enough. If bleeding, prolapse, or pain continues despite appropriate care, the next step may be an office procedure or surgery depending on the diagnosis.
Which non-surgical procedures may be considered?
Selected internal hemorrhoids can be treated with office-based procedures. Options used in clinical practice include rubber band ligation, injection sclerotherapy, and infrared coagulation. These procedures act in different ways to reduce blood flow, shrink tissue, or create controlled scarring that supports the prolapsing tissue.
Office procedures are generally intended for internal hemorrhoids and are not interchangeable with treatment for painful external hemorrhoids. The appropriate choice depends on hemorrhoid grade, bleeding, prolapse, medications such as blood thinners, previous procedures, and the clinician’s assessment. Availability also varies.
Some patients need more than one treatment session, and recurrence can occur. An office procedure may be preferable to surgery for suitable disease because recovery is often shorter, but it may not be adequate for large external hemorrhoids, combined disease, or advanced prolapse.
When is hemorrhoid surgery usually considered?
Surgery may be discussed when one or more of the following apply:
- Large grade III or grade IV prolapsing internal hemorrhoids cause significant symptoms
- There are substantial external hemorrhoids or combined internal and external disease
- Bleeding, prolapse, pain, discharge, or hygiene difficulty remains troublesome despite appropriate conservative care
- Office procedures have not provided sufficient or lasting relief
- Symptoms repeatedly return and significantly affect work, sleep, mobility, exercise, or daily life
- A thrombosed external hemorrhoid causes severe pain and the timing and examination support a procedure
- There is strangulated or irreducible prolapsed tissue requiring prompt surgical assessment
- The diagnosis or anatomy requires treatment that cannot be managed adequately in the clinic
The presence of hemorrhoids alone is not a reason for surgery. The decision should be based on symptoms, examination findings, treatment history, expected benefit, recovery burden, and the patient’s informed preference.
Patients who may need an operation can learn more about piles surgery in Sharjah at Emirates European Hospital.
What types of hemorrhoid surgery are available?
The term hemorrhoid surgery covers several techniques. The right method depends on whether the problem is internal, external, or combined; the amount of prolapse; previous treatment; and the surgeon’s findings.
Excisional hemorrhoidectomy
Hemorrhoidectomy removes symptomatic hemorrhoidal tissue. It is commonly considered for large external hemorrhoids, combined internal and external disease, or advanced prolapse. It can provide durable symptom relief, but postoperative pain and recovery are generally greater than with office procedures.
Stapled hemorrhoidopexy
This technique repositions prolapsing internal tissue and interrupts part of its blood supply using a circular stapling device. It is not suitable for every pattern of disease and may not address a substantial external component. The surgeon should explain expected benefits, recurrence considerations, and procedure-specific risks.
Other selected techniques
Other approaches may include vessel-targeted ligation, suturing, or techniques marketed as laser treatment. “Laser” describes an energy tool rather than a single standardized operation, and it should not automatically be assumed to be painless, risk-free, or superior. Patients should ask exactly what will be performed, why it fits their anatomy, and how its outcomes and risks compare with alternatives.
The EEH piles surgery service lists laser, stapled, and conventional approaches for selected patients. Final procedure selection is made after surgical assessment.
Can hemorrhoid surgery be performed as one-day surgery?
Many suitable hemorrhoid procedures can be planned as day surgery, meaning the patient is assessed, treated, monitored during early recovery, and discharged on the same day when medically safe. Same-day discharge is not guaranteed for every patient.
Suitability depends on the procedure, anesthesia plan, bleeding risk, medical conditions, pain control, ability to pass urine, recovery after anesthesia, home support, and the surgeon’s and anesthetist’s assessment. Patients should arrange transport and follow the hospital’s instructions about fasting, medications, and postoperative support.
The General Surgery Department at Emirates European Hospital provides one-day surgery options in Sharjah for selected procedures and patients.
What should you expect before surgery?
Preoperative planning may include a review of medical conditions, allergies, previous operations, current medicines, bleeding risk, and anesthesia history. The team may request blood tests or other investigations depending on age, health, and the planned procedure.
Do not stop aspirin, anticoagulants, diabetes medicines, or other prescribed treatment without instructions from the treating team. The surgeon should explain:
- The exact diagnosis and why surgery is being proposed
- The recommended technique and reasonable alternatives
- Expected pain, wound care, and time away from activities
- Possible bleeding, infection, urinary, bowel, and anesthesia risks
- The chance of recurrence or persistent symptoms
- When to restart medicines and normal eating
- Who to contact after discharge
Is hemorrhoid surgery painful?
Discomfort is expected after many hemorrhoid operations because the anal area is sensitive and moves during bowel movements. The degree and duration vary according to the procedure, amount of tissue treated, individual pain response, stool consistency, and healing.
A structured plan may combine prescribed pain relief, warm baths when advised, adequate fluids, fiber, and medication to prevent hard stool. Patients should use only the medicines recommended for them. Some strong pain medicines can worsen constipation, which can make recovery more difficult.
No responsible provider should promise a completely painless operation. A better question is how pain will be prevented, monitored, and treated, and when worsening pain should trigger reassessment.
How long does recovery take?
Recovery varies widely. Some office procedures allow a quick return to normal activities, while excisional surgery generally requires a longer period of pain control, wound care, and activity adjustment. The surgeon can provide a more useful estimate after selecting the procedure.
During early recovery, patients may be advised to keep stool soft and regular, avoid heavy straining, use warm baths, take medication as directed, and gradually resume activity. A small amount of spotting may occur after some procedures, but the treating team should define what is expected.
Contact the hospital promptly if bleeding is heavy or does not settle, pain is rapidly worsening, fever develops, swelling or discharge increases, you cannot pass urine, you cannot pass stool despite the treatment plan, or you feel faint or unwell.
What are the possible risks of hemorrhoid surgery?
Risks depend on the technique and the patient’s health. They may include:
- Pain and swelling
- Early or delayed bleeding
- Urinary retention
- Infection
- Constipation or stool impaction
- Delayed wound healing
- Narrowing of the anal canal
- Changes in continence, which are uncommon but important to discuss
- Recurrence or persistent symptoms
- Risks related to anesthesia
Risk is not identical for all procedures. Informed consent should compare the recommended option with non-operative care and other reasonable procedures in the context of the patient’s specific condition.
Can hemorrhoids return after treatment?
Yes. Recurrence is possible after lifestyle treatment, office procedures, and surgery, although the likelihood differs by disease severity and treatment. Continued constipation, diarrhea, prolonged straining, and toilet habits may contribute to new or recurrent symptoms.
Long-term prevention focuses on regular bowel habits rather than trying to make every bowel movement extremely soft. A balanced fiber intake, appropriate fluids, physical activity, and early management of persistent constipation or diarrhea can help reduce strain.
What about hemorrhoids during pregnancy?
Hemorrhoids are common during pregnancy and after childbirth because of pressure, hormonal changes, constipation, and straining. Many cases improve with conservative measures and time. Medication and procedures require individualized obstetric and surgical advice because not every product or intervention is appropriate during pregnancy or breastfeeding.
Heavy bleeding, severe pain, a rapidly enlarging lump, fever, or symptoms that do not improve should be assessed. The timing of any procedure is decided according to severity, gestational or postpartum status, and the patient’s overall health.
Can women request a female hemorrhoid surgeon in Sharjah?
Yes. Some patients feel more comfortable discussing anorectal symptoms with a female surgeon. Dr. Seena Al Masalmeh is a Specialist General Surgeon at Emirates European Hospital with more than 14 years of experience. Her verified profile includes a special interest in modern and minimally invasive treatment for hemorrhoids and other anorectal conditions.
Patients may request an appointment with Dr. Seena, subject to availability. Consultations are handled professionally and should include clear explanation, consent, and respect for privacy.
Hemorrhoid assessment and surgery in Sharjah
Emirates European Hospital provides diagnosis and individualized treatment planning for hemorrhoids and related anorectal symptoms through its General Surgery Department. Management may range from bowel-habit changes and medication to selected procedures or surgery, depending on the diagnosis and severity.
To arrange an assessment with a general surgeon or request a female surgeon, book an appointment in Sharjah or call 06 561 9444.
This article provides general educational information and does not replace a medical examination, diagnosis, emergency assessment, or individualized treatment plan from a qualified healthcare professional.