Options for External Hemorrhoid Removal: Relieving Pain and Discomfort Surgically

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In some cases, lifestyle changes such as eating a well-balanced diet and getting more exercise are enough to relieve the symptoms of hemorrhoids and prevent new hemorrhoids from forming. Some patients also use topical creams and ointments to relieve the pain, itching, irritation, swelling and other symptoms of hemorrhoids. When these treatments don’t work, external hemorrhoid removal and other surgical procedures may be necessary to relieve discomfort.

Blood Clot Removal

Blood clots develop within some external hemorrhoids, increasing discomfort and other symptoms. Blood clot removal allows the surgeon to make a small invision in the hemorrhoid and remove the problematic clot. This procedure is done on an outpatient basis, so it does not require a hospital stay. Without this procedure, the blood clot can cause a lump around the anus, resulting in sudden pain. If the clot dissolves on its own, it can leave a skin tag in its place, resulting in additional irritation and discomfort.

Minimally Invasive Hemorrhoid Removal

When hemorrhoids cause chronic pain or persistent bleeding, your health care provider may suggest other solutions, such as removing hemorrhoids with other minimally invasive procedures typically performed in an outpatient setting. These include sclerotherapy and coagulation. Sclerotherapy involves an injection of chemicals into hemorrhoid tissue. The injected solution eventually shrinks the hemorrhoid without causing the patient much pain. However, sclerotherapy is not always effective and more surgery might be required. Coagulation involves the use of laser, infrared or bipolar tools to remove a hemorrhoid. Laser or infrared light or heat causes hardening in hemorrhoids, and they eventually shrivel away. However, coagulation often results in hemorrhoids returning, requiring other surgery.

Surgical Removal

When other procedures aren’t successful for healing or removing hemorrhoids, surgery might be the only option. Although a hospital stay might be required in some cases, outpatient surgery is an option. Hemorrhoid removal, called hemorrhoidectomy, is when excessive tissue is surgically removed. Typically, local or spinal anesthetics are used during the procedure, but they are often combined with sedation. Patients usually return to work within 7 to 10 days after the procedure. External hemorrhoid removal is the most effective way to eliminate problematic hemorrhoids. However, a hemorrhoidectomy often has complications, such as bladder or urinary tract problems and post-surgery pain. Medications and soaking regularly in a warm bath may relieve these side effects. The Harvard Medical School estimates that this procedure cures 95 percent of hemorrhoid cases.

An alternative surgical procedure is hemorrhoid stapling, called stapled hemorrhoidectomy. Stapling blocks blood flow to eliminate the hemorrhoid. It is typically less painful than a regular hemorrhoidectomy but can produce more complications post-surgery. Discuss treatment options for external hemorrhoid removal with your health care provider and talk about trying natural methods, including lifestyle changes, before opting for surgery.


1. Mayo Clinic: Hemorrhoids


2. Swedish: Colon and Rectal Clinic