With over 30 years of surgical experience, Dr. Rajeev Kapoor has treated patients suffering from both early and advanced stages of piles (hemorrhoids). While many cases improve with medication and lifestyle correction, some require surgical intervention for permanent relief.
A common question patients ask is:
“When do piles need surgery?”
The answer depends on the severity, grade, symptoms, and response to conservative treatment.
What Are Piles (Hemorrhoids)?
Piles are swollen and inflamed veins in the rectum or around the anus. They develop due to increased pressure in the lower rectum, often caused by:
- Chronic constipation
- Straining during bowel movements
- Pregnancy
- Obesity
- Prolonged sitting
There are two types:
Internal Hemorrhoids
Located inside the rectum and usually painless but may cause bleeding.
External Hemorrhoids
Present under the skin around the anus and can be painful, especially if thrombosed.
Early diagnosis and proper lifestyle guidance as part of professional Hemorrhoid Treatment in Chandigarh can help manage mild cases without the need for surgery.
Symptoms of Piles
Common symptoms include:
- Bright red bleeding during bowel movement
- Pain or discomfort while passing stool
- Anal itching or irritation
- Swelling near the anus
- Tissue protruding outside the anus (prolapse)
Mild cases often respond to medicines and dietary changes. Persistent or severe symptoms may require surgery.
Grading of Internal Hemorrhoids
Understanding the grade helps determine treatment:
Grade I
Bleeding without prolapse.
Grade II
Prolapse during straining but reduces on its own.
Grade III
Prolapse that requires manual reduction.
Grade IV
Permanently prolapsed and cannot be pushed back.
Surgery is usually considered for Grade III and Grade IV hemorrhoids.
When Is Surgery Necessary?
Surgical treatment is recommended in the following situations:
1️⃣ Persistent Bleeding
If bleeding continues despite medication, it can lead to anemia and weakness.
2️⃣ Severe Pain
Especially in thrombosed external hemorrhoids.
3️⃣ Recurrent Prolapse
When hemorrhoids repeatedly come out and need manual reduction.
4️⃣ Failure of Conservative Treatment
If dietary modifications, medications, and non-surgical procedures fail after several weeks.
5️⃣ Complications
Such as strangulated hemorrhoids or infection.
Ignoring advanced piles can significantly affect quality of life, and in such cases, consultation for Piles Surgery in Chandigarh may be recommended for long-term relief.
Surgical Options for Piles
Treatment choice depends on severity and patient factors.
1️⃣ Conventional Hemorrhoidectomy
This is the surgical removal of hemorrhoidal tissue.
Advantages:
- Permanent removal
- Very low recurrence rate
- Effective for large Grade III & IV piles
Considerations:
- Post-operative pain for a few days
- Recovery time 1–2 weeks
It remains the gold standard for advanced hemorrhoids.
2️⃣ Stapler Surgery (Stapled Hemorrhoidopexy)
This technique repositions prolapsed hemorrhoidal tissue using a circular stapling device.
Benefits:
- Less post-operative pain
- Faster recovery
- Shorter hospital stay
Best suited for prolapsing internal hemorrhoids.
3️⃣ Laser Treatment for Piles
A minimally invasive technique where laser energy shrinks hemorrhoidal tissue.
Advantages:
- Minimal bleeding
- Reduced pain
- Early return to normal activity
However, patient selection is crucial for optimal results.
Is Surgery Safe?
Modern hemorrhoid surgeries are:
- Safe
- Performed under regional or general anesthesia
- Associated with high success rates
Complications are rare when performed by an experienced surgeon.
Recovery After Piles Surgery
Most patients can:
- Resume light activities within a few days
- Return to work in 5–10 days (depending on procedure)
- Experience significant symptom relief within weeks
A high-fiber diet and proper hydration are essential post-surgery to prevent recurrence.
Can Piles Turn Into Cancer?
No, piles themselves do not turn into cancer. However, rectal bleeding should never be ignored, as it can also be a symptom of more serious conditions such as colorectal cancer. Proper evaluation is essential.
When Should You Consult a Surgeon in Chandigarh?
Seek medical evaluation if you experience:
- Repeated rectal bleeding
- Severe anal pain
- Prolapsed tissue that does not reduce
- Symptoms lasting more than 2–3 weeks
Early intervention prevents complications and improves outcomes.
Conclusion
Not all piles require surgery — but advanced, painful, or persistent hemorrhoids often do. The right time for surgery depends on symptom severity, grade, and response to conservative treatment.
Timely evaluation ensures effective treatment and long-term relief.
