Conservative Treatment (at Early Stages):
- Prescription of venotonics to strengthen the vascular walls
- Use of anti-inflammatory and analgesic ointments and suppositories
- Sitz baths with antiseptic solutions
- Dietary adjustments to normalize bowel movements
- Physiotherapy methods to reduce swelling and inflammation
Main Surgical Methods for Treating Acute Hemorrhoids
1. Thrombectomy of a Hemorrhoidal Node
Indications: Thrombosis of an external hemorrhoid, severe pain, swelling.
Procedure:
- Under local anesthesia, the surgeon makes a small incision in the thrombosed node.
- The thrombus is removed, providing immediate pain relief and reduced swelling.
- The wound heals quickly with rare recurrences.
Advantages: Immediate pain relief, minimally invasive, short recovery period.
2. Laser Vaporization of Hemorrhoidal Nodes
Indications: Thrombosis, advanced hemorrhoid stages, frequent relapses.
Procedure:
- Targeted laser vaporization is performed under local anesthesia.
- Blood vessels are coagulated to prevent bleeding.
- Remaining tissues heal naturally.
Advantages: Painless, fast recovery, low risk of complications.
3. Ligation of Hemorrhoidal Nodes with Latex Rings
Indications: Internal hemorrhoids, stages 2–3.
Procedure:
- A special device places a latex ring around the hemorrhoidal node, cutting off blood supply.
- In 7–10 days, the node dies and is expelled naturally.
Advantages: No incisions, quick procedure, minimal risk of complications.
4. Hemorrhoidectomy (Radical Removal of Hemorrhoidal Nodes)
Indications: Large external or internal nodes, severe stage 3–4 hemorrhoids, complications (bleeding, thrombosis, necrosis).
Procedure:
- Surgical removal of hemorrhoids using stitches or coagulation.
- Either the classical Milligan-Morgan method or the more modern Ferguson technique may be used.
Advantages: Complete problem resolution, low recurrence risk.
Disadvantages: Longer recovery time, possible postoperative pain.
5. Longo Procedure (Stapled Hemorrhoidopexy)
Indications: Internal hemorrhoids, stages 3–4.
Procedure:
- A special surgical stapler removes a portion of the rectal mucosa and pulls the hemorrhoidal nodes upward, cutting off their blood supply.
- The operation lasts about 15–20 minutes.
Advantages: Minimal pain, fast recovery, preservation of rectal anatomy.
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Modern proctology offers effective surgical and minimally invasive technologies. The risks are minimal and largely depend on the surgeon's qualifications and the chosen method of surgical treatment for hemorrhoids. With minimally invasive procedures (thrombectomy, laser vaporization or ligation), serious complications are rare. After radical hemorrhoidectomy, pain may occur in the first few days and is managed with medication. The proctologists at Helios Medical Center follow modern European protocols. This makes it possible to minimize surgical risks and create the conditions for a smooth recovery.
Recovery times depend on the method of surgical treatment for acute hemorrhoids. After thrombectomy and laser vaporization, the patient usually returns to normal life within 2–3 days. After latex band ligation — within 3–5 days. Hemorrhoidectomy requires a longer recovery — on average 2–4 weeks.
The Longo procedure usually takes about 15–20 minutes and provides a shorter recovery period compared with classic hemorrhoidectomy. During recovery, a high-fiber diet, limited physical activity and scheduled check-ups with a proctologist are recommended.
The indications for surgery in acute hemorrhoids are determined by the stage of the disease and the clinical presentation. In the early stages of acute hemorrhoids, conservative treatment is often sufficient — taking venotonics, anti-inflammatory drugs, and using antiseptic sitz baths. Thrombectomy is indicated for thrombosis of an external hemorrhoidal node with severe pain. For internal hemorrhoids of stages 2–3, latex band ligation is effective. At stages 3–4, with large nodes, frequent recurrences or complications, hemorrhoidectomy or other surgical methods may be used, including the Longo procedure when appropriate indications are present. A proctologist at Helios Medical Center will determine the treatment method individually based on the examination.
Recurrences of hemorrhoids after surgery largely depend on the patient's lifestyle. Key preventive measures include a diet with sufficient fiber and adequate water intake to normalize bowel movements, avoiding spicy food and alcohol, moderate physical activity and avoiding prolonged sitting. It is important to prevent constipation, since it is one of the main causes of the recurrent formation of nodes. A proctologist at Helios Medical Center will provide detailed recommendations on preventing recurrences at discharge.
