Hemorrhoidectomy

Who Is a Good Candidate for Hemorrhoidectomy?

Hemorrhoidectomy is often used for patients who have either Grade 3 or Grade 4 hemorrhoids that have not responded to other treatments.

Surgical removal becomes the better path when these patterns appear:

• Persistent Bleeding: Rectal bleeding that continues despite topical treatments, dietary changes and other interventions warrants surgical evaluation.
• Recurring Thrombosed Hemorrhoids: When blood clots form repeatedly inside external hemorrhoids, causing sharp pain and a hard lump near the anus.
• Failed Office Treatments: Patients who have tried banding, infrared coagulation or sclerotherapy without lasting relief.
• Mixed Internal and External Hemorrhoids: Combined cases involving both types of tissue may need surgery to address everything in one setting.
• Anemia from Bleeding: When chronic blood loss causes low iron or hemoglobin levels.

Preparing for Your Hemorrhoidectomy

Before the procedure, the patient should tell their doctor about their full medical history and provide a detailed medication list. Those taking medications that thin the blood may need to temporarily stop these or alter the dosage to reduce the risk of bleeding following the surgery. Smoking should also be stopped before the surgery since it can impede healing. Up to 12 hours before the scheduled procedure, patients may be asked to refrain from beverages or food.

Anesthesia Options for Hemorrhoidectomy

Prior to the procedure, there are three types of anesthesia the doctor can use to ensure that patients are comfortable:

• Local anesthesia to numb the area where the hemorrhoid is located
• Spinal anesthesia to ensure the lower body is numb
• General anesthesia to put the patient to sleep

What Happens During a Hemorrhoidectomy Procedure

There are different procedures that fall under the hemorrhoidectomy umbrella. The best one will depend on the patient’s hemorrhoid, the severity of symptoms and their overall health.

1. Conventional Hemorrhoidectomy: A conventional hemorrhoidectomy involves locating the hemorrhoid and making small incisions around it. The surgeon then takes scissors, a knife or a cautery pencil to remove the hemorrhoid.
2. Rubber Band Ligation or Stapling: The second type of this procedure involves blocking the flow of blood to the hemorrhoid. This results in the hemorrhoid shrinking since it will no longer have the nutrients it requires to survive. The flow of blood is blocked by either placing a rubber band around the growth or using staples.
3. Laser or Chemical Treatment: The third option uses either a laser or a special chemical solution. If the chemical is used, it is injected into the hemorrhoid. Both of these options work by helping to shrink the hemorrhoid so that it is not able to cause significant symptoms.

On the day of surgery, you will meet with your anesthesiologist, after which your team will place an IV and begin monitoring your heart rate and blood pressure. Dr. Syn will perform the surgery, which varies in time depending on how many hemorrhoids are addressed. You will then go to a recovery area to allow the anesthesia to wear off before going home.

Recovery After Hemorrhoidectomy

For most patients, the recovery period is approximately two weeks. Most patients will not have to stay overnight and can go home shortly after the procedure. However, they should have a ride since driving might not be safe. The doctor may prescribe medications, and these should be taken exactly as directed to promote comfort during recovery.

• Day of Procedure: Expect grogginess, mild bleeding, and discomfort that prescribed pain medication should manage.
• Days 1-3: This window is typically the most uncomfortable, with pain peaking around day three. You can use stool softeners and sitz baths to help during this time.
• Days 4-7: Pain should begin to ease noticeably. You can take short walks to help with circulation, but avoid heavy lifting and prolonged sitting. A donut-shaped cushion or soft pillow reduces pressure when you need to sit.
• Days 7-10: Most office workers feel ready to return to a desk job. Bowel movements become more comfortable as healing progresses, though minor bleeding can still occur.
• Weeks 2-3: Patients in physically demanding roles typically return to work during this window. You can gradually reintroduce moderate exercise, but continue avoiding heavy lifting until cleared by Dr. Syn.
• Weeks 4-6: Follow-up visits at our Lake Forest, Irvine or Mission Viejo offices allow Dr. Syn to confirm everything is on track and answer any questions.

All Hemorrhoid Treatment Options at Orange County Hemorrhoid Clinic

Not everyone needs to have surgery for their hemorrhoids. We have many more options for those who are not good candidates for surgery or who have a milder case. Our team includes Dr. Kevin Burns, a board-certified interventional radiologist who exclusively performs imaging-guided procedures every day and has helped pioneer minimally invasive hemorrhoid treatments, and Dr. Gene Syn, a board-certified and fellowship-trained colorectal surgeon with over 20 years of experience.

Hemorrhoid Banding

A small elastic band is placed at the base of an internal hemorrhoid during a quick in-office visit, cutting off its blood supply so the tissue shrinks and falls off within about a week. Rubber band ligation is one of the most widely used hemorrhoid treatments because it's effective, requires no anesthesia, and patients can return to normal activity right away.

• Best For: Grade 1, Grade 2, and some Grade 3 internal hemorrhoids that haven't responded to dietary changes or topical treatments.

Hemorrhoid Banding >>

Infrared Coagulation (IRC)

This treatment uses a probe and a focused light beam to create scar tissue that cuts off blood supply to small internal hemorrhoids, causing them to shrink. IRC is quick, requires no anesthesia, and patients return to normal activity immediately. Each session takes only a few minutes, and multiple hemorrhoids can be addressed during the same visit.

• Best For: Small Grade 1 and Grade 2 internal hemorrhoids.

Infrared Coagulation >>

Hemorrhoid Embolization (HAE)

This image-guided technique blocks the small arteries supplying problematic hemorrhoids, causing them to shrink without any cutting or removal of tissue. It is performed by Dr. Kevin Burns, who guides a catheter through an artery in the wrist or upper thigh without any cuts or access to the rectal area. Recovery is rapid because there is no surgical wound to heal.

• Best For: Patients with chronic bleeding hemorrhoids (Grade 1-3) who want to skip surgery, as well as those with health conditions that make surgical recovery riskier.

Hemorrhoid Embolization >>

Heat Energy Therapy (HET™)

Low-energy heat is applied directly to hemorrhoidal tissue through a small probe, causing the swollen veins to shrink and seal without incisions or sutures. HET™ is performed in our office and typically takes just a few minutes per hemorrhoid. Only one session is usually needed for results.

• Best For: Grade 1 and Grade 2 internal hemorrhoids, especially for patients who want an option that can treat the hemorrhoid in one session.

Heat Energy Therapy >>

Transanal Hemorrhoidal Dearterialization (THD)

Doppler ultrasound is used to locate the small arteries feeding hemorrhoids, which are then tied off so the swollen tissue shrinks on its own. Transanal hemorrhoidal dearterialization addresses the root vascular cause of hemorrhoids without removing tissue, which translates to less post-operative pain than conventional surgery.

• Best For: Grade 2 and Grade 3 internal hemorrhoids when in-office treatments have not provided lasting relief.

Transanal Hemorrhoidal Dearterialization >>

Why Choose Orange County Hemorrhoid Clinic?

Hemorrhoids are all we do. Orange County Hemorrhoid Clinic focuses exclusively on hemorrhoid and colorectal care, so our team performs these treatments daily. At our clinic, you benefit from a faster diagnosis and a deeper familiarity with every treatment option.

Two specialists, one coordinated team. Patients have access to both a board-certified colorectal surgeon and a board-certified interventional radiologist under the same roof for a wide range of treatment options.

Dr. Gene Syn brings over 20 years of colorectal surgery experience. He is fellowship-trained and board-certified by both the American Board of Surgery and the American Board of Colon and Rectal Surgery. He specializes in rectal surgeries, and his care, the time he spends with patients and his ability to simplify the problem put his patients at ease, even when they would rather be somewhere else.

Dr. Kevin Burns leads our non-surgical hemorrhoid treatment. A board-certified interventional radiologist trained at Brown University, NYU, Montefiore, and MD Anderson, Dr. Burns has pioneered image-guided hemorrhoid embolization for patients who want lasting relief without an operation.

Three convenient Orange County locations. Our offices in Lake Forest, Irvine and Mission Viejo accept most PPO insurance plans and Medicare, with scheduling flexibility for working professionals.

Hear From Our Patients

“Dr. Syn guided me through the most painful and also the most psychologically challenging part of my life that I ever had to endure. He is truly a talented and gifted doctor. And just as importantly, he takes the time to explain all of your options and truly cares about your medical situation and all of the things that you are going through. I am so thankful for Dr. Syn and the guidance and support he gave to me over the course of my treatment. I would highly recommend him.”

— Eric

“Went to Dr. Syn's office in Laguna Hills for my hemorrhoid issues. Professional, good communicator, addresses questions, and works efficiently. Banding procedures were effective. I highly recommend Dr. Syn because he has helped me to live more comfortably.”

— RM

“I had a fantastic experience [with the] doctors office and staff here in Orange County. The level of care and professionalism was outstanding. . .I received the help I needed to find relief quickly, which made a huge positive impact on my quality of life, including allowing me to enjoy a recent trip to Hawaii.”

— Markell B.

FAQs About Hemorrhoidectomy

How long does a hemorrhoidectomy procedure take?

Surgical time typically ranges from 30 to 60 minutes, depending on the number of hemorrhoids removed and the technique chosen. Including check-in, anesthesia and recovery, plan for about four to five hours at the surgical center.

Will I be able to have a bowel movement after my surgery?

Yes, and patients are encouraged to avoid delaying. Most people have their first bowel movement within 24 to 48 hours after surgery. We recommend immediately beginning stool softeners, fiber supplements and adequate water intake to make this more manageable. Holding back leads to harder stools and more discomfort.

Is a hemorrhoidectomy covered by insurance?

Most PPO plans and Medicare cover hemorrhoidectomy when it's medically necessary, which is the case for the vast majority of patients who reach the point of needing surgery. Our team verifies your benefits before scheduling, so there are no surprises.

Can hemorrhoids come back after surgery?

Hemorrhoidectomy has the lowest recurrence rate of any hemorrhoid treatment, with fewer than 5% of patients developing new hemorrhoids in the same area. New hemorrhoids can still form in different locations, especially without changes to fiber intake, hydration and bathroom habits.

Will I need stitches, and do they need to be removed?

Most hemorrhoidectomy techniques use absorbable sutures that dissolve as tissue heals, so no removal visit is required.

Are there restrictions for getting a hemorrhoidectomy?

Patients with uncontrolled bleeding disorders, active infections in the surgical area or certain heart conditions may need to delay surgery or consider alternatives. During your consultation, Dr. Syn reviews your medical history thoroughly to confirm this is the right treatment.

Can internal and external hemorrhoids be removed in the same surgery?

Mixed cases involving both internal and external components are routinely addressed in a single operation. Treating everything at once spares patients from a second recovery and produces a more thorough result.

Are there any risks and complications?

As with all surgical procedures, there are possible risks that patients should be aware of. These include:

• Infection
• Stool leakage
• Bleeding
• Pain that makes passing urine difficult

Get Relief From Hemorrhoids With Hemorrhoidectomy in Orange County

If conservative care has not resolved your symptoms, there is still another option. Surgical removal is one of the most reliable treatments for severe forms of hemorrhoids, and Dr. Syn specializes in this type of surgery.

Call Orange County Hemorrhoid Clinic at 949-238-1126 to schedule a consultation at our Lake Forest, Irvine or Mission Viejo office. Our team will review your history and walk you through every treatment available so you can make a confident decision about next steps.