If the at-home treatments don't help and you're still suffering symptoms for after a week, you may need a medical procedure. Typically, the treatment will involve different techniques to cause scar tissue to form in the hemorrhoids. This cuts off the blood supply and usually shrinks the hemorrhoid. The most common medical procedure that your doctor may use is called a rubber band ligation. Here, a small band is placed around the base of the hemorrhoid, cutting off its blood supply from the vein. Patients often find rubber band ligation to be painful, and it often results in bleeding. However, the hemorrhoid will usually shrivel and fall off within a week. Rubber band ligation is successful for about 80% of patients, and only 10% need surgery as a follow-up treatment. Another procedure is sclerotherapy. Here, the doctor injects a chemical solution into the hemorrhoid to shrink it. It is a much less painful procedure than rubber band ligation. Still, it may not be as effective as treating the hemorrhoid in, the longer term with 30% of the patients suffering a reoccurrence within four years. Other less common procedures include electrical coagulation, where an electrical current is used to stop the blood flow to an internal hemorrhoid. Your doctor may also try infrared coagulation, where they insert a small probe into the rectum that transmits heat to get rid of the hemorrhoid. Both coagulation treatments do not usually cause discomfort and they aim to make the internal hemorrhoid harden and shrink. In severe cases, you may need surgery. Around five to 10% of patients will need a hemorrhoidectomy after at-home treatments have failed. A hemorrhoidectomy surgically removes large external hemorrhoids or prolapsed internal ones. Alternatively, your doctor may recommend hemorrhoid stapling. This procedure is used for internal hemorrhoids and involves using a stapling instrument to either remove the internal hemorrhoid or pull a prolapsed one back into the anus and hold it there.
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