What is the quickest way to remove a hemorrhoid?

Quickest Ways to Remove Hemorrhoids

For the quickest resolution of hemorrhoids, surgical excision under local anesthesia is recommended for thrombosed external hemorrhoids within 72 hours of symptom onset, while rubber band ligation is the most effective office-based procedure for symptomatic internal hemorrhoids (grades I-III). 1, 2

Treatment Based on Hemorrhoid Type and Timing

External Hemorrhoids

• For thrombosed external hemorrhoids presenting within 72 hours:

  • Surgical excision under local anesthesia provides fastest symptom resolution and lower recurrence rates 2
  • Simple incision and drainage alone is NOT recommended due to persistent bleeding and higher recurrence rates 2

• For thrombosed external hemorrhoids presenting after 72 hours:

  • Conservative management is preferred as the natural resolution process has begun 1, 2
  • Topical 0.3% nifedipine with 1.5% lidocaine ointment applied every 12 hours for two weeks shows 92% resolution rate 1, 2

Internal Hemorrhoids

• Rubber band ligation is the most effective office-based procedure with success rates of 70.5-89% 1

  • Works by tightly encircling redundant tissue, causing necrosis and subsequent scarring 1
  • Can be performed in an office setting without anesthesia 1
  • Up to 3 hemorrhoids can be banded in a single session 1

• For more advanced cases (grade III-IV):

  • Conventional excisional hemorrhoidectomy is the most effective treatment overall with recurrence rates of only 2-10% 1, 3
  • Provides more definitive resolution but involves longer recovery (9-14 days) 3

Pharmacological Options for Symptomatic Relief

• For rapid symptom relief while awaiting definitive treatment:
  • Topical analgesics like lidocaine provide quick pain and itching relief 4
  • Short-term topical corticosteroids (≤7 days) reduce local inflammation 1, 4
  • Flavonoids improve venous tone and can control acute bleeding 4, 3
  • Sitz baths (warm water soaks) reduce inflammation and discomfort 1

Important Considerations and Pitfalls

• Timing is crucial for thrombosed external hemorrhoids - surgical intervention within 72 hours provides quickest relief 2
• Avoid long-term use of corticosteroid creams/suppositories (>7 days) as they can thin perianal and anal mucosa 1, 4, 2
• Cryotherapy and anal dilatation should be avoided due to prolonged pain, foul-smelling discharge, and risk of incontinence 1
• Ensure proper diagnosis - hemorrhoids may coexist with more serious pathology requiring different treatment 5
• Conservative measures should accompany all treatments, including increased fiber and water intake 1, 4, 3

Special Populations

• For pregnant women:

  • Conservative management is preferred with dietary fiber, adequate fluid intake, and bulk-forming agents 1
  • Hydrocortisone foam can be used safely in the third trimester 1

• For immunocompromised patients:

  • Avoid rubber band ligation due to increased risk of necrotizing pelvic infection 1
  • Conservative management with topical treatments is preferred 1

Remember that while quick relief is desirable, the most appropriate treatment depends on hemorrhoid type, grade, and duration of symptoms. For long-term resolution, addressing underlying causes through dietary and lifestyle modifications remains essential 1, 3.