Dealing with hemorrhoids – any advice?

Hey everyone, so this past Sunday I ended up with some massive "external hemorrhoids"—or honestly, I think it might be perianal thrombosis since I haven't really dealt with internal hemorrhoid issues before. After doing some chamomile baths, applying Fact cream, and using some St. John's Wort oil... things have calmed down a little bit. The inflammation has gone down, but they're still there, about the size of a pea. I was wondering what those of you with more experience here would suggest I do? I was thinking about asking my doctor to prescribe Daflon, since I've seen quite a few of you mention how much it helped.
Surgery? What is that actually like? And what does the recovery phase look like?

Hello everyone. I just wanted to reach out and share my experience with you all. I dealt with both external and internal hemorrhoids at stage 4—pain, burning, itching... I went through every single symptom. In April 2013, I underwent surgery under local anesthesia using the Hal-RaR method. There was some pain afterward, and some bleeding during bowel movements, but honestly, compared to what I was dealing with before, it was manageable—you just hope things will improve, and besides, pain is such a subjective thing. For a while, everything was fantastic; I was actually marveling at how wonderful it felt to have a "normal" backside again and not have to worry about every bathroom trip. Unfortunately, the issue returned after 6-7 months, and about a year later, things were worse than ever. I had a hemorrhoid prolapse after a bowel movement that was roughly the size of a small apple—a total catastrophe, frankly. So, a week ago, I went back under the knife for the Hal-RaR method with the same doctor. The worst part is that I already have a prolapse right after this second surgery, and now I’m just waiting for my first follow-up to see what happens next—hoping everything turns out okay. If it doesn't, I am prepared to go through this cycle repeatedly until it's fixed. Believe me, life without hemorrhoid issues is so much better—don't let fears of pain hold you back. You can trade long-term misery for a short period of discomfort in exchange for being able to truly live and enjoy yourself. What causes them? Everything... stress, mental health, diet, genetics, sitting too much, dehydration, temperature changes, even the pace of your life. As I said, please don't skip exams or treatment because you're scared; the percentage of people who face chronic issues or recurrences is extremely low—and unfortunately, I'm one of those people. If you think I'm just talking nonsense, I can scan both of my discharge papers for you. Just go to the doctor and get your problems sorted out. :-)

Susan Turner60, would you mind sharing which clinic performed the procedures? Personally, I’m happy to share my own experience. I have grade 2 and 3 hemorrhoids, and after dealing with heavy bleeding and spending a total of 16 days in the hospital due to needing blood transfusions, it was a nightmare. I had to endure endless, uncomfortable exams—even though the doctors at one hospital decided to run every test under the sun, including gastroscopy, colonoscopy, enteroscopy, and scintigraphy, despite the initial digital rectal exam already pointing toward hemorrhoids. I went through all that just so they could finally rule out chronic diseases, only to be handed a discharge paper that basically said, "patient discharged without a definitive diagnosis..." So, I went looking for a second opinion and ended up being admitted to a different hospital under a high-quality doctor who actually knows his stuff. He only needed a rectoscopy and a colonoscopy to reach a diagnosis: internal hemorrhoids with sensitive mucosa that carry a massive risk of bleeding. The doctor also told me straight up that he didn't want to perform a classic surgical removal because it’s incredibly painful, and since I’m young—only 30—he didn't want me dealing with those kinds of complications. After that, I sought out Dr. Ivanovic regarding the HAL-RAR procedure. To be honest, he’s the only doctor I trust to handle this, but obviously, it’s private practice at the butterfly clinic. The waiting lists elsewhere are insanely long, and I’m still trying to figure out the finances because even their prices are a bit steep for my current situation. My advice to everyone: I am much wiser and more experienced now. If I were back at square one with these symptoms, I’d head in for an exam the very second they started. Getting checked out is way less uncomfortable and painful than the actual problems hemorrhoids cause. I put myself in a dangerous position by needing six units of blood, which isn't something you want to go through. Now I’m anemic, even though I never had issues before and used to be a regular blood donor. Take hemorrhoid problems seriously. Don't delay—get an exam or talk to specialists immediately. There are good people out there who can help.

Look, if you’re happy with a certain doctor and feel comfortable recommending them to someone else, just do it. If you’re too shy to post it publicly, then send a private message. This shouldn't just be about you; it should apply everywhere.

People don't come to this forum out of boredom; they come here looking for actual advice and recommendations when they can't find them anywhere else in the real world.

No matter how much I come here searching for a specific recommendation, I never get one. Honestly, I'm just disappointed!

Nicholas Davis27 said:I was wondering if anyone might be able to help me out here... specifically, does anyone have any actual experience using Advil tablets? I’ve been looking online and noticed some are listed for around $599, while others seem to be priced quite differently... $33 I think they go by the name Advil, but these ones are from Himalaya—or at least I think that's the manufacturer... I'm honestly not quite sure if there's actually a real difference between them or if there's some kind of catch somewhere... thanks...

I ended up using some Advil... one of those options you see everywhere... $200About four years ago, I went through something similar and they really helped me out... during that stretch, I was dealing with some pretty annoying hemorrhoids, though most people immediately jump to the conclusion that if you're struggling with them, it means you have irregular digestion. That wasn't actually my situation at all, because my bathroom habits were perfectly regular, yet I still dealt with those occasional flare-ups... and honestly, Advil worked quite quickly for me. They are effective, certainly, but I wouldn't call them a permanent fix—more like temporary relief, which kind of makes sense when you consider how surgeries often turn out to be just a short-term solution rather than a lifelong cure, which was unfortunately my experience too, especially considering what I ended up paying for them... $3833 Kate Allen35... even though I had stage II and still about... $667 If I had known that having the surgery wouldn't actually be a permanent fix, I never would have agreed to go through with it in the first place... instead, I probably would have just taken all that money and invested it into Advil, Daflon, and Fact cream—if I’m remembering the names of all those tablets correctly, which is a big if since I might end up needing them all over again... My honest advice to anyone considering going to a private specialist for surgery—especially if you're looking at Hal-RaR—is to ask right upfront if a follow-up procedure is included in the initial cost... Surgeons always claim this specific procedure is incredibly successful, but they tend to gloss over the fact that hemorrhoids can definitely come back, and it's likely a much higher rate than the measly 5% they like to quote... Then, when things don't hold up, they expect you to cough up more cash, even though you already paid for a procedure that wasn't done quite right the first time... Hal-RaR can be quite effective, but sometimes only if it's repeated a few times, which obviously hits your wallet hard because very few doctors are willing to do a repeat procedure for free, and as for how truly permanent the results are, well, only time will tell...

Emily Watson62 said:I used Advil (one of $200) about four years ago and they really helped me. During that time, I was dealing with hemorrhoids. Most people assume if you have hemorrhoid issues, it means your digestion is irregular, but that wasn't my case at all. My bowel movements were perfectly regular; I just had occasional flare-ups, and Advil worked quickly to help. Advil is effective, but let’s be real—it’s a temporary fix, not a permanent cure. In the end, we see that even surgeries often aren't permanent solutions either. That was my experience. I paid $3833 Kate Allen35 for the surgery even though I only had stage II, and then had to shell out another $667 just to have the procedure repeated. If I had known surgery wouldn't be a long-term fix, I never would have agreed to it. I would have much rather invested that money into Advil, Daflon, and Fact cream (if I remember those names correctly—I might need them again soon). My advice to anyone considering private surgery (especially HAL-RAR) is to ask immediately if a follow-up procedure is included in the price. Surgeons claim it's highly successful, but they don't mention how common recurrence actually is—it's definitely higher than the 5% they claim. Then, they expect you to pay again, even though you already paid for a botched initial surgery. HAL and HAL-RAR can work, but sometimes they require multiple attempts, which is a huge hit to your wallet since almost no one gets a free redo. Only time will tell if they truly are a permanent solution.

Who performed your surgery? It would be good for people to know so they can avoid such an unskilled provider. A stage II issue can often be resolved without needing RAR. Also, is it possible you did something you weren't supposed to do, causing the recurrence? It might not even be the doctor's fault.

Preparation H cream. Help!

cosmicviper18 said:Look, if you’re happy with a specific doctor and feel comfortable recommending them to someone else, then go ahead and do it. If you’re too shy to say it publicly, just send a private message. This shouldn't just be about you; it should apply to everyone else here, too.

People don't come to this forum because they're bored; they come here specifically looking for advice or recommendations when they can't find them anywhere else in the real world.

No matter how much I come here searching for a specific recommendation, I never seem to find one. Honestly, it's pretty disappointing.

It isn't about being "shy." To me, mentioning a specialist I personally vouch for means naming Dr. Ivanovic at Mercury or the Butterfly clinic. Also, the surgeon who clearly nailed my diagnosis and pinpointed my biggest issue was Dr. Lackovic. I can't say exactly where he's practicing now since he changed locations, but he's the kind of guy who might not be the most chatty person right off the bat, but he absolutely knows his stuff!

Hello everyone... A few months back, I noticed a swollen, bluish vein appearing just above the anal opening, and it seems quite prominent; whenever I deal with particularly hard stools, the pain becomes quite intense, and I've started noticing blood on the tissue when I wipe. Looking in the mirror, I can see this engorged vein where the skin almost seems to split right down the middle, which is where the bleeding occurs... Could this be a hemorrhoid, or am I misinterpreting things? Should I perhaps try some local treatment prescribed by a primary care physician to see if it offers any relief over the next few days? For context, I follow a standard food pyramid diet, drink about three liters of water daily, and exercise every single day, yet I still struggle with the realities of a sedentary job.

Hey, so even though I've been dealing with hemorrhoids for a while now, lately things have taken a turn for the worse—it’s started stinging and burning every time I hit the bathroom. My doctor finally gave me a prescription for Fact cream. Now I'm wondering, how often am I supposed to be applying this stuff, and for how long? And honestly, does this actually clear things up after a bit... or am I just destined to be best friends with this tube for the rest of my life? Thanks

Hey everyone. I’ve been dealing with hemorrhoids since high school, so we’re talking like a decade of this misery. When I first saw blood, the shock was so bad I actually passed out—and honestly, there was a decent amount of it—but anyway... moving on. Sometimes things were better, sometimes they weren't. Back when it hit hard, I’d just take some Daflon and everything would settle down after three or four days. It used to only flare up once or twice a year, nothing crazy. But over this last year, my digestion has gone completely off the rails. I managed to sort out the bloating, the gas, and those stomach issues, but I haven't been able to get my bowel movements under control, which means the hemorrhoids have become a daily nightmare. I mean, I’m hitting the bathroom three or four times a day now; two or three times in the morning, then maybe one more in the afternoon or evening. Plus, I always feel like I haven't fully cleared out in the morning, so I have to keep going back. My stools are either super thin or coming out in little pellets, and the hemorrhoids are just constantly there; I don't usually have a major bleeding problem, but the pain and itching are pretty much a permanent fixture. It feels like the Daflon doesn't even touch it anymore, maybe because I've used it so much? I don't know what the hell has happened to my system this past year. Has anyone else dealt with something similar? Or should I just bite the bullet, grab a referral, and finally go see a specialist?

Come on, at least they’ll give you the right cream...

Hey everyone.
It looks like a lot of you deal with this, so I’m hoping someone can help me out. Basically, yesterday this lump popped up right by my anus, and the pain is just brutal. I’m assuming it’s a hemorrhoid. The real kicker is that since yesterday, I haven't been able to sit, lie down, or even walk properly without struggling. I picked up some Preparation H and have been applying it, but it isn't doing much for the pain. What’s really stressing me out is that because it’s sitting right on the opening, I can't even imagine how I'm going to handle a bowel movement with this thing there. It hurts so bad I'm honestly at a loss. I read somewhere that ice helps—is that actually true, or am I just going to make things worse?
How do you guys manage to go to the bathroom when your hemorrhoids are flaring up like this?

Grab some painkillers like Advil or Voltaren to take, and definitely pick up some Tylenol gel at the pharmacy to rub on before you head to the bathroom.

Well, I’m officially scheduled for "the knife." Grade III—one big one, two small ones. The creams don't touch it anymore; surgery is unavoidable. Gotta get it done ASAP.
So, I've gotta know—does any public hospital besides Mercury actually perform THD or DG-HAL?
And does anyone know a private clinic where it costs less than ten grand?! 😁
Is it any cheaper over in Canada or Mexico?
This is unbelievable—it's like paying ten thousand bucks for thirty minutes of work... 😲

Anyway, the guy I saw for my exam claims he only recognizes Morgan-Milligan as the way to go. Says it's the only permanent fix and that all this "new stuff" hasn't been proven and the problem will definitely come back.
But based on everything I’ve read over the last few months—both here and on various other sites—everyone seems to say that while M-M comes with horrific post-op pain, it practically guarantees a recurrence compared to THD/DG-HAL, which supposedly has a success rate of 95%+.
So, you tell me how to be smart here. Why the hell were these new methods even introduced if M-M is such a sure thing? 🤔
Or is it just a case of "every doctor praises his own horse," while the patient gets screwed?

Dana Baker2 said:Well, I’m officially facing the knife too. Grade III. One big one, two small ones. The creams aren't cutting it anymore, so surgery is inevitable. Needs to happen ASAP.
So I’m wondering, does any public institution besides Mercury offer THD or DG-HAL?
And for private clinics, is there anywhere cheaper than 10 grand?! 😁
Is anything more affordable over in Canada or Mexico?
This is unbelievable—it's like paying ten times the effort for half the result... 😲

By the way, the guy I saw for my exam claims he only recognizes Morgan-Milligan. He insists it's the only permanent fix and that all these "new" methods are unproven and will definitely lead to the problem coming back.
But after everything I've read here and on various other sites over the last few months, everyone seems to say that aside from horrific post-op pain, M-M practically guarantees a recurrence, unlike THD/DG-HAL where the success rate is 95%+.
Now you tell me to be smart. Why on earth were these new methods even introduced if M-M is supposedly the gold standard? 🤔
Or is it just a case of "every doctor praises his own horse" while the patient gets screwed?

HAL with the RAR addition when anal area reconstruction is needed is the most effective. Practically 100% success rate. Everything else is just nonsense...

Michael Diaz4 said:HAL with the RAR add-on is the gold standard when you need rectal area reconstruction. It’s practically a 100% success rate. Everything else is just a waste of time...

What does "reconstruction" actually entail here? And when is it even necessary versus when it isn't?
From what I can gather, there's no cutting involved with either THD or DG-HAL—so how the hell does the reconstruction part even work?
Honestly, I haven't even figured out the actual difference between those two methods yet. 😁
Sorry if I'm pestering you, but since you've been through the whole ringer yourself, you're clearly the best person to ask.

Dana Baker2 said:What does reconstruction actually entail? And when is it necessary versus when is it not?
From what I gather, there’s no cutting involved in either THD or DG-HAL. So how does the reconstruction part even happen?
To be honest, I haven't quite wrapped my head around the difference between these two methods yet. 😁
Sorry if I'm pestering you, but since you've been through the whole ordeal yourself, you're clearly the best person to ask.

RAR stands for rectal area reconstruction. It's typically performed for third or fourth-degree cases. You can find plenty of detailed info and helpful links about it here on the forum. As for THD (Transanal Hemorrhoidal Dearterialization), it's an incredibly safe and successful minimally invasive approach. It's an outpatient procedure, so you're in and out in one day. Using Doppler technology, the surgeon pinpoints the exact location of the hemorrhoidal arteries, ties them off, and repositions the tissue where it belongs. This technique doesn't remove any tissue; instead, it essentially acts as a "de facto" reshaping of the perianal area. Patient satisfaction is generally very high, and most people are back at work and enjoying life again within 24 to 48 hours.

DG-HAL + RAR method: Much like THD, this method is designed to target the root cause of enlarged hemorrhoidal nodes—treating the actual source of the disease. By placing transanal sutures, the arteries supplying blood to the diseased node are tied off. This is done using a Doppler ultrasound probe to precisely locate the terminal branches of the hemorrhoidal arteries. Since the sutures are placed in a section of the rectum that lacks sensory nerves, there is no pain. Because there is no cutting or tissue damage, the function of the hemorrhoidal area remains almost entirely intact. To make things even more comfortable, the procedure is done under local or spinal anesthesia; general anesthesia isn't required. Patients go home the same day, and most can return to their normal routines within just a day or two.

Michael Diaz4 said:RAR refers to anal area reconstruction—usually done for stage three or four cases. There’s plenty written about this here along with some good links. Regarding the THD (Transanal Hemorrhoidal Dearterialization) method: THD stands for Transanal Hemorrhoidal Dearterialization. It’s a very safe, successful, minimally invasive approach. The procedure is outpatient, meaning you go home the same day. THD uses Doppler technology to pinpoint the exact location of the hemorrhoidal arteries; then, those arteries are tied off, and the tissue is repositioned where it belongs. This technique doesn't actually remove tissue—it's essentially a "de facto" reshaping of the perianal area. Patient satisfaction with this method is high, and most people expect to get back to work and their normal routine within 24 to 48 hours.

DG-HAL + RAR method: Much like the THD method, this one is designed to tackle the root cause of enlarged hemorrhoidal nodes—basically treating the actual source of the disease. By using transanal sutures, the arteries supplying blood to the diseased hemorrhoidal node are tied off. They use a Doppler ultrasound probe to find the exact terminal branches of those arteries. Since the sutures are placed in a part of the bowel without sensory nerves, there's no pain. Because nothing is being cut or damaged, the function of the hemorrhoidal node stays almost entirely intact. To keep things comfortable, the surgery is done under local or spinal anesthesia—no need for general anesthesia. Patients head home the same day, and most can jump back into daily life in just 1 or 2 days.

I’ve already read all that, don't worry. But both THD and DG-HAL mention using Doppler to tie off the arteries. So what's the actual difference?
And regarding RAR—when exactly is it needed for stage III, seeing as both THD and DG-HAL are also used for stage III, right?

Anal reconstruction becomes necessary once hemorrhoids prolapse and can't be pushed back in manually. Personally, I think HAL is the superior choice because it's such a more modern approach. There aren't even pain receptors in the specific area where the procedure is performed. If you catch it during the early stages of the condition, they don't perform RAR, so there's virtually no pain or time taken off work.