From the Guidelines
Hemorrhoid treatment for men should prioritize nonoperative management, with surgical hemorrhoidectomy reserved for severe cases, such as large third- or fourth-degree hemorrhoids, or when nonoperative management fails, as recommended by the American Gastroenterological Association 1. For mild hemorrhoids, lifestyle changes and medical interventions can be effective, including:
- Increasing fiber intake to 25-30 grams daily
- Drinking plenty of water
- Avoiding straining during bowel movements
- Using over-the-counter treatments, such as topical creams containing hydrocortisone, witch hazel pads, and oral pain relievers like acetaminophen or ibuprofen
- Taking warm sitz baths for 15 minutes, 2-3 times daily For persistent or severe hemorrhoids, medical procedures may be necessary, including:
- Rubber band ligation
- Sclerotherapy
- Infrared coagulation
- Surgical removal (hemorrhoidectomy) in extreme cases It's essential to seek medical attention if symptoms don't improve after a week of home treatment, or if severe pain, heavy bleeding, or other complications occur, as these may require professional intervention 1.
From the Research
Hemorrhoid Treatment for Males
- Hemorrhoids are a common medical condition characterized by painless rectal bleeding during defecation with or without prolapsing anal tissue 2.
- Treatment options for hemorrhoids vary depending on the type and severity of the condition, with external hemorrhoids usually requiring no specific treatment unless they become acutely thrombosed or cause discomfort 2.
- Internal hemorrhoids can be effectively treated with medication and non-operative measures such as rubber band ligation and injection sclerotherapy for low-graded cases 2, 3.
- Surgery is indicated for high-graded internal hemorrhoids, or when non-operative approaches have failed, or complications have occurred 2, 4.
- Minimally invasive procedures such as stapled hemorrhoidopexy, doppler-guided hemorrhoidal artery ligation, and transanal hemorrhoidal dearterialization (THD) have been developed as alternatives to conventional hemorrhoidectomy for advanced hemorrhoids 3, 5, 4.
- These minimally invasive procedures focus on reducing blood flow to the hemorrhoids and have been shown to be effective in improving symptoms such as bleeding and prolapse 5.
- However, the recurrence rate after these procedures can be higher than that of conventional hemorrhoidectomy, and patients should be informed of the potential risks and benefits 5, 4.
Treatment Options for Advanced Hemorrhoids
- Conventional hemorrhoidectomy (CH) is considered the standard treatment for Grade III and IV hemorrhoids due to its low recurrence rate 5.
- Stapled hemorrhoidopexy is a minimally invasive procedure that elevates Grade III or IV hemorrhoids to their normal anatomic position by removing a band of proximal mucosal tissue 3, 4.
- Transanal hemorrhoidal dearterialization (THD) is another minimally invasive procedure that has been shown to be effective in treating Grade III and IV hemorrhoids 5.
- Hemorrhoidal artery ligation may be useful in Grade II or III hemorrhoids, as it can reduce pain and promote quicker recovery 4.
Non-Surgical Treatment Options
- Medical management, including stool softeners, topical over-the-counter preparations, and topical nitroglycerine, is often the first line of treatment for hemorrhoids 4.
- Dietary modifications, such as increased fiber and water intake, and behavioral therapies, such as sitz baths, can also be effective in managing symptoms 4.
- Rubber band ligation is a common office-based procedure for treating Grade I to III internal hemorrhoids, with a lower failure rate than infrared photocoagulation 4.