Category: Blog

Most people try to handle hemorrhoids on their own first. You increase your fiber intake, pick up a tube of over-the-counter cream, and maybe start taking warm baths after work. For a lot of people, this works. Symptoms fade, and life moves on.

But home treatment has limits, and knowing where those limits are isn’t always obvious. 

Because hemorrhoids are so common, it can be easy to keep treating recurring symptoms as something you simply have to manage. Certain changes, however, can be a sign that it’s time for a professional evaluation.

At Orange County Hemorrhoid Clinic, our patients have access to the full range of treatment, from conservative management through minimally invasive and surgical options, in one place. Here are five signs that it may be time to move past home care.

When Home Treatment Works, and When It Stops Working

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) reports that hemorrhoids affect about 1 in 20 Americans, and about half of adults older than age 50 have them. The American Society of Colon and Rectal Surgeons notes that hemorrhoidal disease accounts for more than 2.2 million outpatient evaluations in the United States each year, making it one of the more common reasons people see a specialist.

For mild, low-grade hemorrhoids, conservative measures such as added fiber, more water, sitz baths and topical treatments genuinely help. But hemorrhoids don’t always stay mild. As they progress, straining and pressure continue to aggravate the same tissue, and those measures alone can’t reverse that pattern. Recognizing when your symptoms have crossed that line is the first step toward treating the hemorrhoid itself rather than managing its symptoms indefinitely.

The 5 Signs to Watch For

Not every hemorrhoid follows the same path, but a few patterns tend to show up again and again in patients who eventually need more than fiber and creams to feel better. Knowing what those patterns look like can help you decide it’s time to book a consultation.

1. Bleeding That Lingers Past a Week or Keeps Coming Back

Occasional light bleeding from mild hemorrhoids can happen, but bleeding that continues for more than a week, or that shows up again and again, should be evaluated by a physician. Hemorrhoids are the most common cause, but bleeding can occasionally point to something else that needs a closer look, and the earlier it’s evaluated, the more treatment options are typically on the table. 

2. A Hemorrhoid That Won’t Stay In

When a hemorrhoid prolapses, or bulges outside the anus, and no longer retracts on its own, home treatment usually isn’t enough to reverse it. This is generally the difference between a Grade 2 hemorrhoid, which pulls back in after straining, and a Grade 3 or 4 hemorrhoid, which needs to be pushed back manually or stays out permanently. Persistent prolapse is a strong indicator that in-office or minimally invasive treatment is the next step, since this type of tissue rarely improves on its own.

3. Sudden, Severe Pain With a Firm Lump

Sharp, intense pain paired with a hard, swollen lump near the anus often points to a thrombosed hemorrhoid. A thrombosed hemorrhoid forms when a blood clot develops inside the swollen tissue, cutting off normal blood flow and causing the area to become tender, firm and often bluish in color. Outcomes tend to be best when it’s addressed within the first few days of symptoms starting, which makes this a sign worth calling about the same day it appears.

4. Symptoms That Keep Returning No Matter What You Try

If you’ve been through repeated cycles of flare-ups and short-lived relief for months at a time, that pattern itself is a sign the underlying hemorrhoid needs treatment, rather than more symptom control. Chronically enlarged hemorrhoidal tissue doesn’t respond to fiber and hydration the way newer, milder hemorrhoids do. Patients in this position often describe trying every remedy available before finally asking whether a more targeted option exists.

5. Fatigue or Other Signs You Wouldn’t Expect

Chronic, low-level bleeding from hemorrhoids can lead to iron-deficiency anemia over time, and fatigue, weakness or lightheadedness may be the first clue that something beyond the hemorrhoid itself needs attention. The NIDDK lists anemia as a recognized complication of hemorrhoids. In one study of patients treated with rubber band ligation, anemia reverted significantly once the hemorrhoids were successfully treated, a reminder that fatigue can be easy to overlook as a hemorrhoid symptom.

What Happens If You Wait

Untreated hemorrhoids don’t typically resolve on their own once they’ve progressed past the early stages. Left alone, prolapse tends to worsen, bleeding tends to continue, and thrombosed tissue can become more painful and harder to treat the longer it’s left untreated.

Waiting can also mean fewer options later. A Grade 1 or 2 hemorrhoid, if caught early, may respond well to a quick in-office procedure. A Grade 4 hemorrhoid that’s gone untreated for years, on the other hand, is more likely to require hemorrhoidectomy, which comes with a longer recovery. Addressing symptoms while they’re still manageable generally means a shorter recovery.

Who Should See a Specialist Now

If you’re still not sure whether your symptoms cross the line into “see someone about this,” these four questions are a good gut check. If any of them sound familiar, it’s a reasonable signal to schedule a visit.

• You’ve had symptoms for more than two weeks: Short flare-ups can resolve on their own, but symptoms lasting beyond two weeks despite home care usually need a professional evaluation.
• You’ve noticed blood more than once: A single instance can happen with straining, but recurring blood on tissue or in the bowl is worth having checked.
• A hemorrhoid has prolapsed and stayed out: Tissue that doesn’t retract on its own, or that you have to push back manually, won’t resolve with fiber or creams alone.
• You’re avoiding activities because of discomfort: If sitting, exercising or traveling has become something you plan around, that’s a sign your hemorrhoids are affecting daily life more than they should.

None of these, on their own, mean something is seriously wrong, but together they’re a useful way to gauge whether you’ve moved past the point where home treatment can catch up. If one or more apply to you, that is your cue to book a consultation rather than wait for symptoms to settle down.

Getting the Right Treatment, Not Just Any Treatment

One of the biggest advantages of seeing a specialist is that hemorrhoid treatment isn’t one-size-fits-all, and the right option depends on the grade, type and severity of what you’re dealing with. At Orange County Hemorrhoid Clinic, that range includes:

• Hemorrhoid banding, an office-based procedure that cuts off blood flow to an internal hemorrhoid using a small rubber band. A study published in Diseases of the Colon & Rectum reported a cumulative success rate of 80.2 percent for banding across initial and repeat treatments, making it one of the more well-established non-surgical options. 
• Infrared coagulation and heat energy therapy are two in-office treatments suited to smaller or earlier-stage internal hemorrhoids.
• Hemorrhoid embolization (HAE), a minimally invasive, non-surgical option performed by Dr. Burns that reduces blood flow to internal hemorrhoids through a catheter placed in the wrist or thigh, with no cutting or removal of anorectal tissue.
• THD treatment and, for more advanced cases, hemorrhoidectomy, are performed by Dr. Syn when surgical removal offers the most definitive, long-term resolution.

Matching your grade, symptoms and history to the right option happens at your consultation, so you start with the treatment most likely to work the first time.

Why Patients Choose Orange County Hemorrhoid Clinic

With Dr. Gene Syn and Dr. Kevin Burns working together, your case is evaluated from both surgical and non-surgical perspectives before any recommendation is made. Dr. Burns trained at Brown University and NYU School of Medicine, completed his residency at Montefiore Medical Center and pursued advanced interventional radiology training at MD Anderson Cancer Center. Dr. Syn brings more than 20 years of surgical and procedural experience in colorectal care. If a quick in-office treatment will solve your problem, we’ll tell you. If your case calls for something more involved, we’ll explain why so the recommendation you get reflects two specialties weighing in, not a single default approach.

We also accept most PPO insurance plans and Medicare, and our team is happy to help verify coverage and handle preauthorizations before you commit to a treatment plan. With offices in Lake Forest, Irvine and Mission Viejo, care is available close to home, no matter where in Orange County you are.

Schedule a Consultation at Orange County Hemorrhoid Clinic

If your symptoms fit any of the signs above, getting them evaluated is a faster path to relief than waiting out another round of home treatment. A consultation gives you a clear answer about your grade, your options and what’s realistic for your recovery, whether that means a same-day in-office procedure or something more involved.

Call Orange County Hemorrhoid Clinic at (949) 238-1126 or book an appointment online to get started. We see patients at our Lake Forest, Irvine and Mission Viejo offices.

Hemorrhoids have a way of taking over parts of daily life. You skip a workout, choose an aisle seat on a flight or keep a cushion in the car without really thinking about why. Each small adjustment feels manageable on its own, but over weeks and months, they add up to a quality of life you didn’t choose.

Knowing when to treat hemorrhoids instead of just living with them isn’t always obvious. Many people wait months or years to seek help, often assuming surgery is the only next step when home remedies stop working. At Orange County Hemorrhoid Clinic, we help patients understand when symptoms can still be managed at home and when they may benefit from professional treatment, including non-surgical options that can often provide lasting relief.

Mild Hemorrhoids vs. Hemorrhoids That Need Treatment

Internal hemorrhoids are graded on a scale of one to four based on severity and whether they prolapse, meaning they bulge outside the anus.

• Grade 1: Stay internal and may bleed occasionally, without prolapsing
• Grade 2: May prolapse during a bowel movement but retract on their own
• Grade 3: Prolapse and need to be pushed back into place manually
• Grade 4: Are permanently prolapsed and won’t retract, even with manual pressure

Grade alone doesn’t tell the whole story. A grade 1 hemorrhoid that bleeds every week deserves more attention than a grade 2 that flares up once a year. What matters more than the label is the pattern: how often symptoms appear, how much they interfere with daily life and whether they’re getting better or worse over time.

Hemorrhoids are also far more common than most people realize. According to the National Institute of Diabetes and Digestive and Kidney Diseases, they affect about 1 in 20 Americans, and roughly half of adults over age 50 have dealt with them at some point. If you’re living with this, you’re in the company of a large number of people who rarely bring it up.

Signs You Need Hemorrhoid Treatment

There’s no single symptom that means surgery is next. But a few patterns tend to show up in patients who are ready to move past home care.

Recurring Bleeding

A single spot of blood after a hard bowel movement isn’t automatically alarming. Bleeding that shows up week after week, even in small amounts, is worth having evaluated. Any rectal bleeding should be checked by a physician, since hemorrhoids aren’t the only possible cause, and conditions like polyps or inflammatory bowel disease can present with similar symptoms.

Symptoms That Shape Your Schedule

Choosing an aisle seat, avoiding certain workouts or timing your morning around when the bathroom is free are all signs that symptoms have outgrown home management.

Home Treatments That Have Stopped Working

Fiber, sitz baths and over-the-counter creams help many people, especially early on. If you’ve given these a genuine trial of several weeks without improvement, that plateau is meaningful information.

Prolapse That Won’t Stay In Place

Tissue that needs to be pushed back in, or that no longer retracts on its own, typically points to a more advanced grade that needs a procedural solution rather than more time.

Fatigue, Paleness Or Shortness Of Breath

Chronic blood loss, even in small amounts, can lead to iron deficiency over months or years. If you’ve noticed fatigue alongside ongoing hemorrhoid symptoms, mention both to your doctor.

Why Patients Wait Longer Than They Should

Embarrassment plays a bigger role in this decision than most people admit. A 2025 study published in the Journal of Clinical Medicine found that only about 30.8% of people with hemorrhoidal symptoms had ever sought medical advice for them, and interestingly, the presence of rectal bleeding wasn’t a strong predictor of who actually went to a doctor. In other words, many people learn to live with a symptom that their own physician would want to know about.

Part of the hesitation also comes from the assumption that treatment automatically means surgery. That assumption is outdated. Most patients today have several non-surgical paths available before hemorrhoidectomy ever enters the conversation. Many patients have simply never heard of options like embolization or heat energy therapy, so surgery is the only reference point they have. Once patients understand the full range of what’s available, scheduling an evaluation tends to feel far less daunting.

Waiting also tends to make the eventual conversation harder. Symptoms that have been present for years are often more advanced by the time a patient finally comes in, which can narrow the list of appropriate treatments. Bringing symptoms up earlier, even mild ones, generally means more options rather than fewer.

What Happens Once You Decide to Treat

Getting ready for treatment starts with a conversation, not a commitment to any single procedure. A doctor can walk you through which option fits your situation.

At Orange County Hemorrhoid Clinic, that conversation starts with a straightforward in-office exam to confirm the grade and pattern of your hemorrhoids. We’ll also ask how long symptoms have been present, what you’ve already tried at home and how they’re affecting your daily routine, since that context shapes which treatment makes the most sense. There’s no pressure to commit to a procedure at this first visit. The goal is simply to give you an accurate picture of where you stand and what your realistic choices are. 

Depending on severity, options may include:

• Rubber band ligation: A small band is placed at the base of the hemorrhoid to cut off its blood supply, causing it to wither and fall off within about a week. It requires no anesthesia, can be done in minutes and is effective in roughly 80% of appropriate cases.
• Infrared coagulation: A small probe delivers infrared light to create scar tissue that cuts off blood flow to the hemorrhoid. Sessions typically take under ten minutes and work well for smaller hemorrhoids, though more than one session may be needed.
• Heat energy therapy: Low-grade heat is applied near the hemorrhoid to reduce blood flow and inflammation. It’s typically done in a single session, with patients returning to normal activity the same day.
• Hemorrhoid artery embolization (HAE): A board-certified interventional radiologist threads a small catheter through the wrist or upper thigh to reduce blood flow to the hemorrhoidal tissue, with no cutting, banding or trauma to the rectum itself.

Surgical hemorrhoidectomy remains an option too, generally reserved for advanced grade 3 and 4 cases or situations where less invasive treatments haven’t provided lasting relief.

A Simple Self-Check Before Your Appointment

If you’re still on the fence, ask yourself these questions honestly:

• Have my symptoms lasted longer than a week or two?
• Have I noticed bleeding more than once?
• Have I changed my daily routine, exercise habits or travel plans because of this?
• Have home remedies failed to help after a genuine trial period?
• Am I avoiding this conversation out of embarrassment rather than because I think it isn’t a big deal?

Answering yes to two or more of these is a reasonable signal that it’s time to schedule an exam rather than wait it out further. A few extra weeks of “let’s see if it clears up” rarely change the outcome and often just extend the discomfort.

Why Orange County Residents Choose Us For This Decision

This decision is easier when the person examining you can offer every option, not just the one they happen to perform.

Dr. Gene Syn, a fellowship-trained colorectal surgeon with more than 20 years of experience and Dr. Kevin Burns, a board-certified interventional radiologist who trained at Brown University, NYU School of Medicine and MD Anderson Cancer Center, work together at our practice to cover the full range of surgical and non-surgical hemorrhoid care under one roof. Dr. Burns grew up in nearby Laguna Niguel and has focused his career on bringing minimally invasive hemorrhoid treatment to patients in Southern Orange County who might otherwise assume surgery is their only path forward.

Because both specialties are represented in-house, your treatment plan gets built around your anatomy and your preferences rather than around whichever single procedure one doctor happens to offer. You will hear it plainly if HAE is the better fit for your case, or if a simpler in-office procedure would solve the problem just as well.

We see patients at three Orange County locations, in Lake Forest, Irvine and Mission Viejo, Monday through Friday, and we accept most PPO insurance plans as well as Medicare. Once you’ve decided treatment makes sense, getting an appointment nearby shouldn’t be another barrier.

Schedule a Consultation For Hemorrhoid Treatment

Hemorrhoids are widespread, but that’s no reason to keep working around them indefinitely. A short consultation can tell you exactly where you fall on the spectrum and what your realistic options are, without any commitment beyond that first conversation. For long-term prevention, once your symptoms are under control, our guide to hemorrhoid prevention covers daily habits that help keep them from returning.

Call Orange County Hemorrhoid Clinic at (949) 238-1126 or schedule a consultation online. A consultation includes a symptom review and an honest answer about which treatment path, if any, is right for you.

If you have searched for the “best” or “most effective” hemorrhoid treatment, you have probably noticed that the answer depends on who you ask.  A pharmacist might point you toward creams. A primary care doctor might recommend increasing your fiber intake. A surgeon might suggest a hemorrhoidectomy.

Each of these answers can be correct, depending on the situation. The truth is that no single treatment works best for every patient. The most effective treatment is the one that matches your hemorrhoid grade, symptoms, and recovery goals.

At Orange County Hemorrhoid Clinic, we see patients every week who have tried one or two treatments without lasting relief and want to understand what else is available. This guide walks through the full range of options, from conservative care to surgery, so you can have an informed conversation with your provider about what might work best for you.

Why “Most Effective” Depends on Your Hemorrhoid Grade

Hemorrhoids are graded on a scale from 1 to 4 based on severity:

• Grade 1 hemorrhoids are small and stay inside the rectum. 
• Grade 2 hemorrhoids prolapse during straining but retract on their own. 
• Grade 3 hemorrhoids prolapse and need to be pushed back in manually. 
• Grade 4 hemorrhoids are permanently prolapsed and cannot be reduced.

A treatment that works well for grade 1 hemorrhoids may do little for grade 3, and a treatment designed for grade 4 may be more invasive than what a grade 2 patient needs. This is why the most effective treatment is not a fixed answer. It is a moving target that depends on where your hemorrhoids fall on this scale, the length of symptoms, and the conservative options you have already tried.

Conservative Treatments: When They Work and When They Stop Working

For grade 1 and many grade 2 hemorrhoids, conservative care is often the right starting point. This includes increasing dietary fiber, drinking more water, using topical treatments and adjusting bathroom habits to reduce straining.

These approaches address the pressure patterns that contribute to hemorrhoid formation, and for some patients, they are enough to manage symptoms long term. The challenge is that conservative care does not shrink hemorrhoids that have already enlarged. If bleeding, itching, or prolapse continue after several weeks of consistent effort, it is a sign that the hemorrhoids need a more direct treatment.

Office-Based Procedures: Banding, Coagulation, and Heat Therapy

When conservative care is not enough, the next step is usually a minor in-office procedure: 

• Hemorrhoid Banding: Places a small rubber band around the base of an internal hemorrhoid, cutting off its blood supply so it shrinks and falls away.
• Infrared Coagulation: Uses targeted heat to seal the blood vessels feeding a hemorrhoid.
• Heat Energy Therapy: Works on a principle similar to infrared coagulation, but via a different delivery method.

These procedures are quick, require no anesthesia beyond local numbing in most cases, and work well for many grade 1 and grade 2 hemorrhoids. However, they treat one hemorrhoid at a time, and patients with multiple symptomatic hemorrhoids may need several sessions. Recurrence is also possible, particularly for patients whose hemorrhoids are larger or more numerous than these methods are designed to address.

Surgical Options: Hemorrhoidectomy and THD

For grade 3 and grade 4 hemorrhoids, or for patients who have not responded to less invasive options, surgery has traditionally been considered the most effective answer:

• Hemorrhoidectomy: Removes the hemorrhoidal tissue directly and is highly effective at preventing recurrence.
• THD Treatment: Stitches off the blood supply to the hemorrhoids without removing tissue, a less invasive alternative to traditional hemorrhoidectomy.

Both options carry the tradeoffs that come with any surgical procedure performed at or near the anal canal. Recovery can include significant pain in the first one to two weeks, time away from work, and a healing period that requires careful management.

For patients who need a definitive surgical solution, these remain valuable options. For patients who want to avoid surgery altogether, there is another path worth understanding.

Hemorrhoid Artery Embolization: A Newer Benchmark for Effectiveness

Hemorrhoid artery embolization (HAE) approaches the problem from a different angle. Rather than treating the hemorrhoidal tissue directly, an interventional radiologist accesses the superior rectal artery through the wrist or upper thigh and places tiny coils to reduce blood flow to the swollen vessels. Without that blood supply, the hemorrhoids shrink over the following weeks.

A 2025 systematic review published in the International Journal of Colorectal Disease pooled data from 22 studies and 810 patients treated with HAE. The review found that arteries were successfully accessed and treated in 93 to 100 percent of cases, with clinical improvement in bleeding and symptoms in 63 to 94 percent of cases. 

Separately, a study in the Journal of Vascular and Interventional Radiology followed 134 patients and reported clinical success in 93 percent at the one-month mark, with significant improvements in both bleeding and quality-of-life scores.

What stands out most is what was absent from these results. Across the pooled data, there were no reported cases of tissue ischemia or loss of continence, two of the more serious concerns associated with treatments that work directly on or near the anal canal. For patients with grade 2 or 3 hemorrhoids who have tried conservative care and want to avoid the recovery period that comes with surgery, HAE has become a meaningful benchmark for what “effective” can look like without an incision.

What Is Actually Most Effective for You?

If your hemorrhoids are small and your symptoms are mild, conservative care or an in-office procedure may be all you need. If your hemorrhoids are larger, recurrent or causing ongoing bleeding, the choice becomes a comparison between surgical options and HAE. Factors like recovery time, anesthesia preferences and how the treatment fits into your life all play a role.

Why Patients Choose Orange County Hemorrhoid Clinic for an Honest Answer

At Orange County Hemorrhoid Clinic, every consultation starts with a review of your symptoms and an honest conversation about which treatments make sense for your situation. We are not trying to fit every patient into one solution. Our practice is led by Dr. Kevin Burns and Dr. Gene Syn, both board-certified, fellowship-trained interventional radiologists who evaluate your hemorrhoid grade, your history with conservative care, and your goals before recommending any treatment.

Continuity matters, too. The physician you meet at your consultation is the same physician who performs your treatment, with no handoff in between. With locations in Lake Forest, Mission Viejo and Irvine, we make it convenient for patients across Orange County to get answers without a long wait or a trip to a large hospital system.

Schedule a Consultation

If you have been searching for the most effective hemorrhoid treatment and are not sure where to start, the best next step is a conversation, not a guess. Call the Orange County Hemorrhoid Clinic at 949-919-6169 or book a consultation online to discuss your symptoms and determine the best treatment for your situation.

For patients struggling with chronic hemorrhoids, deciding what treatment to pursue can feel overwhelming. Many people spend months or even years trying conservative treatments such as fiber supplements, stool softeners, creams and sitz baths before seeking a more permanent solution. Once these methods stop providing relief, surgery is often presented as the next step.

However, surgery is not the only option.

Today, patients may have access to hemorrhoid artery embolization (HAE), a minimally invasive procedure that treats internal hemorrhoids without removing tissue or operating through the anal canal. While hemorrhoidectomy remains an effective treatment for many patients, particularly those with advanced disease, hemorrhoid embolization offers an alternative that may provide symptom relief with less downtime and discomfort.

Understanding the differences between hemorrhoid embolization and hemorrhoid surgery can help you determine which treatment may be the best fit for your needs.

Understanding Internal Hemorrhoids

Hemorrhoids are swollen blood vessels located in the rectum or anus. Internal hemorrhoids develop inside the rectum and may cause symptoms such as:

• Rectal bleeding
• Itching
• Discomfort during bowel movements
• Tissue prolapse
• Mucus discharge
• A feeling of incomplete evacuation

Internal hemorrhoids are generally classified into four grades based on severity.

• Grade 1: Hemorrhoids are enlarged but remain inside the rectum.
• Grade 2: Hemorrhoids prolapse during bowel movements but return on their own.
• Grade 3: Hemorrhoids prolapse and must be manually pushed back inside.
• Grade 4: Hemorrhoids remain prolapsed and cannot be repositioned.

The grade of your hemorrhoids often plays a major role in determining the most appropriate treatment.

What Is Hemorrhoid Artery Embolization?

Hemorrhoid artery embolization is a minimally invasive procedure performed by an interventional radiologist.

Rather than removing hemorrhoidal tissue, the procedure targets the blood vessels that supply the hemorrhoids. By reducing blood flow to these vessels, the hemorrhoids gradually shrink, which can reduce symptoms such as bleeding, swelling and discomfort.

During treatment, a small catheter is inserted through an artery in the wrist or upper thigh. Using advanced imaging guidance, the physician navigates the catheter to branches of the superior rectal artery that feed the hemorrhoids. Tiny coils or particles are then placed into these vessels to reduce blood flow.

The procedure is performed through a tiny puncture site and does not require incisions, stitches or tissue removal.

What Is Hemorrhoidectomy?

Hemorrhoidectomy is a surgical procedure that removes hemorrhoidal tissue.

It is considered one of the most effective treatments for severe hemorrhoids and is commonly recommended for patients with advanced prolapse or large external hemorrhoids.

During the procedure, a colorectal surgeon removes the affected hemorrhoidal tissue and addresses the underlying structures causing symptoms. Depending on the patient and surgical approach, local, spinal or general anesthesia may be used.

While hemorrhoidectomy can provide long-lasting relief, it is generally associated with a more involved recovery period than minimally invasive treatments.

Hemorrhoid Embolization vs. Hemorrhoidectomy

Both procedures are designed to relieve hemorrhoid symptoms, but they differ significantly in how they achieve that goal.

Procedure Approach

Hemorrhoid embolization treats the arteries supplying blood to the hemorrhoids. The hemorrhoidal tissue remains in place but gradually shrinks as blood flow decreases.

Hemorrhoidectomy physically removes hemorrhoidal tissue. Because tissue is excised, the procedure directly addresses prolapse and large hemorrhoids.

Anesthesia Requirements

HAE is typically performed using local anesthesia with mild sedation.

Hemorrhoidectomy may require general anesthesia, spinal anesthesia or deeper levels of sedation depending on the surgical plan.

Pain and Discomfort

Because embolization does not involve cutting or removing tissue, most patients experience relatively little discomfort following treatment.

Hemorrhoidectomy involves operating within a highly sensitive area of the body. As a result, postoperative pain can be more significant, particularly during bowel movements.

Recovery Time

Patients undergoing hemorrhoid embolization typically return home the same day and often resume normal activities within a few days.

Recovery from hemorrhoidectomy is generally longer. Many patients require several weeks before returning to their usual routines, and complete healing may take longer depending on the extent of the procedure.

Treatment Goals

HAE is designed to reduce blood flow and shrink internal hemorrhoids over time.

Hemorrhoidectomy removes hemorrhoidal tissue and may provide more immediate structural correction for severe prolapse.

Who Is a Good Candidate for Hemorrhoid Embolization?

Hemorrhoid artery embolization is often most effective for patients with symptomatic internal hemorrhoids who want to avoid surgery.

You may be a good candidate if:

• You Have Grade 1, 2 or 3 Internal Hemorrhoids: Patients with mild to moderate prolapse often experience the greatest benefit from embolization.
• Rectal Bleeding Is Your Primary Symptom: Many patients seek treatment because of chronic bleeding. HAE directly targets the blood vessels responsible for these symptoms.
• Conservative Treatments Have Failed: Patients who continue experiencing symptoms despite fiber supplementation, dietary changes, creams or banding procedures may benefit from embolization.
• You Prefer a Minimally Invasive Procedure: Many patients choose HAE because it avoids surgical incisions and tissue removal.
• You Want to Minimize Recovery Time: For individuals with work, family or travel obligations, a shorter recovery period can be an important consideration.

Who May Be Better Served by Hemorrhoid Surgery?

While embolization can be highly effective for appropriate candidates, surgery remains the preferred option for certain patients.

• Grade 4 Hemorrhoids: Large, permanently prolapsed hemorrhoids often require surgical correction.
• Significant External Hemorrhoids: External hemorrhoids have a different blood supply and may not respond as effectively to embolization.
• Advanced Prolapse: When structural correction is needed, surgery may provide a more definitive solution.
• Recurrent Symptoms After Multiple Treatments: Patients who have undergone several prior interventions without lasting improvement may benefit from surgical management.

Why Patients in Orange County Choose Us

Orange County Hemorrhoid Clinic brings together surgical and minimally invasive expertise under one roof. Dr. Gene Syn is a board-certified colorectal surgeon who specializes in the diagnosis and treatment of hemorrhoidal disease, while Dr. Kevin Burns is a board-certified, fellowship-trained interventional radiologist who performs hemorrhoid artery embolization and other image-guided procedures. 

This collaborative approach allows patients to receive a comprehensive evaluation and explore both surgical and non-surgical treatment options before making a decision. Every patient undergoes a thorough candidacy assessment, including a review of symptoms, prior treatments and hemorrhoid severity. Because we offer multiple treatment pathways, our recommendations are based on what is most appropriate for the patient rather than a single treatment approach.

Explore Your Hemorrhoid Treatment Options in Orange County

Living with hemorrhoids can affect your comfort, confidence and quality of life. Fortunately, effective treatment options are available. Whether you are interested in a minimally invasive procedure like hemorrhoid artery embolization or need a more definitive surgical solution, a personalized evaluation can help determine the best approach for your symptoms.

At Orange County Hemorrhoid Clinic, patients have access to both hemorrhoid embolization and hemorrhoidectomy, allowing for treatment recommendations based on the severity of the condition, treatment goals and overall health. Call 949-919-6169 or book online to learn more.

Some hemorrhoids go away on their own within a few days, but others may require medical treatment.

What are Hemorrhoids?

Hemorrhoids are inflamed or swollen veins in the lower rectum and anus. Hemorrhoids can be aggravated by:

• Straining during bowel movement
• Sitting for long periods of time
• Constipation
• Frequent diarrhea
• Overuse of laxatives
• Poor diet
• Pregnancy
• Genetic predisposition
• Infection of the rectum

The two types of hemorrhoids are external and internal. External hemorrhoids are located under the skin of the anus and cause itching, pain, and (in some instances) bleeding. Internal hemorrhoids are found inside the anus and eventually pass through and become external hemorrhoids.

How Long Do Hemorrhoids Last?

There isn’t a clear answer to this question. Some patients feel better within a few weeks, while others may need surgery.

Small internal or external hemorrhoids may heal within a week, while larger internal hemorrhoids may last a few months.

Patients experiencing hemorrhoids for the first time may recover faster than patients with recurrent hemorrhoids.

At-Home Treatment For Hemorrhoids

Some patients have recurring hemorrhoids due to weakened supporting tissue in the rectum and anus. To help manage hemorrhoids, patients should:

• Eat high-fiber foods, such as green vegetables and fruits
• Drink lots of water
• Avoid coffee and alcoholic beverages
• Take a fiber supplement or gentle stool softener
• Take warm bath with Epsom salt or sit in a tub with a few inches of warm water at least three times a day for 20 minutes
• Apply over-the-counter hemorrhoid creams
• Stay active and exercise regularly to improve blood circulation and prevent constipation

Patients should avoid straining during a bowel movement, as this can make hemorrhoids worse.

Medical Treatment For Hemorrhoids

Patients may need medical attention if one week of at-home remedies fail to provide relief. Rectal bleeding is another sign that patients need medical attention. Patients experiencing severe pain, bleeding, fever, and abdominal pain should seek medical care immediately.

During a medical appointment, the physician will rule out other potential causes of bleeding, such as Crohn’s disease, ulcerative colitis, and cancer. The physician will perform a visual exam for external hemorrhoids, but internal hemorrhoids will be evaluated using a digital rectal exam or anoscopy.

Patients may be advised to use over-the-counter creams or ointments. Severe hemorrhoids should be treated with creams that contain hydrocortisone and witch hazel.

To remove a blood clot in an external hemorrhoid, the physician may use rubber band ligation. This involves placing rubber bands around the base of the internal hemorrhoids to cut off blood supply and force the hemorrhoid to wither.

Sclerotherapy is another minimally invasive procedure that involves injecting the hemorrhoid tissue with a chemical solution that forces the tissue to shrink.

Depending on the severity of the hemorrhoid, the physician may need to cut off the blood supply and/or cause scar tissue to form, helping to shrink the hemorrhoid. In other instances, patients may need a hemorrhoidectomy to remove large external hemorrhoids and prolapsing internal hemorrhoids.

Hemorrhoid stapling is another surgical procedure done to block blood flow to the hemorrhoidal tissue.

Hemorrhoids are swollen, enlarged veins inside the rectum or located outside the rectum around the anus. They are very similar in nature to the varicose veins that often develop on the lower limbs. They are very common and an estimated 75% of adults will develop one or more hemorrhoids at various times throughout life.

Causes

Many cases of hemorrhoids are related to eating a low-fiber diet. The stools produced from a low-fiber diet tend to cause constipation and the need to strain to pass them, which can lead to the development of hemorrhoids. Hemorrhoids also frequently develop during pregnancy, presumably due to the extra pressure placed on the abdomen by the growing fetus. Some cases of hemorrhoids appear to be related to spending long periods of time sitting on toilets while reading, and they are also not uncommon in bodybuilders who regularly lift very heavy weights. However, in some cases, there is no apparent cause.

Symptoms

External hemorrhoids tend to itch and sometimes can be painful. They may also bleed. Internal hemorrhoids tend to bleed and sometimes one will protrude into the anal opening, causing irritation and pain. If a hemorrhoid bleeds and the blood cannot find an escape route from the hemorrhoid, it will clot and form a hard lump, which may be very painful.

Treatment

You should never assume the blood you observe in the toilet, in your underwear, or in your stool is coming from a hemorrhoid because rectal bleeding can be a symptom of very serious life-threatening diseases. Always consult a doctor for confirmation that your bleeding is indeed coming from hemorrhoids.

Minor cases of hemorrhoids can be treated at home. Over the counter creams can be used to soothe any itching and irritation, but the real treatment revolves around increasing your fiber intake. Most nutritionists recommend eating at least five servings of vegetables every day, which should supply sufficient fiber. However, if you have difficulty in following this advice, whole-grain products, beans, and fiber supplements are other options.

If your hemorrhoids are painful or bleeding a lot, doctors have developed several minimally invasive methods to remove them, including:

• Rubber band ligation
• Sclerotherapy
• Heat coagulation using a laser
• Surgical removal
• Stapling

The best approach varies depending on individual patient factors and the size and number of hemorrhoids and needs to be selected after discussing all of the pros and cons with your doctor.