The reason why patients are resistant to hemorrhoid treatment and surgery is that in addition to the fact that the site is relatively private and the patient does not want to show it, another important reason is out of fear of pain. However, is hemorrhoid surgery really that painful? In fact, with the improvement of medical conditions and medical standards, hemorrhoid treatment and surgical techniques are not what they used to be, and many patients who have undergone clinical surgery in our department have said with regret: Had I known it was so little pain, I certainly would not have put it off until today. So, what level of hemorrhoid treatment technology has been achieved? Just how painful is hemorrhoid surgery? Here’s what real minimally invasive hemorrhoid surgery looks like. External peeling and internal ligation technique. This technique is distinct from both the traditional hemorrhoid circumcision and the very different anastomosis treatment method advocated by many hospitals today. The external peel and ligate technique is very minimally invasive; it involves lifting the hemorrhoid nucleus near the dentate line, using an inverted V-shaped incision, cutting the skin from the top of the external hemorrhoid to the lateral edge of the external hemorrhoid, peeling away the external hemorrhoid tissue, external hemorrhoid vascular collaterals and fibroplastic tissue to about 0.3cm above the dentate line, preserving some of the external hemorrhoid skin, and double ligating the base of the internal hemorrhoid to remove part of the hemorrhoid nucleus. Simply put, this is a true minimally invasive hemorrhoid surgery in which the hemorrhoidal tissue is removed with minimal trauma while preserving the precious anal skin. Minimally invasive means that the surgeon must operate with precision between millimeters, and therefore requires a very high level of skill. But again, because external peeling and internal ligation is the least invasive and least painful, hospitals or anorectal departments in a position to do so are actively preparing to learn and carry it out. Where does the pain of hemorrhoids mainly come from? During surgery, the removal of pain from the patient is the administration of anesthesia. There are usually three types of anesthesia in anorectology: local anesthesia, lumbar anesthesia and general anesthesia, and patients can choose them in relation to their tolerance level. We believe that local anesthesia is appropriate for patients with mild hemorrhoid symptoms or only a single nucleus and internal hemorrhoids that have not yet reached the level of prolapse. For patients with circumferential hemorrhoids or more nuclei, we would recommend lumbar anesthesia if local anesthesia is used, as it has limited infiltration and significant pain and does not get good cooperation from the patient. General anesthesia surgery, on the other hand, is suitable for patients who are super afraid of pain and have poor psychological quality, who are highly nervous even at the thought of surgery, and general anesthesia is administered to such patients so that they can complete the surgery successfully in a completely senseless sleep. However, the type of anesthesia chosen also depends on the differences in individual tolerance. Some people have very high pain domain values, are well tolerated and not overly sensitive, then local anesthesia can be administered even if his condition is slightly severe. And there are patients who are not seriously ill, but because of their extreme sensitivity, they cannot even tolerate finger examination, such patients can also implement lumbar anesthesia, otherwise, not only will the patient feel painful during the operation and cannot cooperate well with the surgeon, but also will bring unnecessary difficulties to the operation. In the postoperative period, because the wound has not yet completely healed, the stool passes through the anal canal, causing friction, which may cause pain. There are several measures to prevent this pain: The first method: before the surgery is completed, the patient is injected with a long-acting anesthetic that usually works for 2-4 weeks, which means that it is in effect while the patient’s wound is healing. The second method: A specialized postoperative analgesic is administered to the patient during the three-day postoperative hospital stay, and oral pain medication is also included in the medications the patient takes with him/her on discharge. Patients are also given herbal sitz baths using an anal wash after a bowel movement, which is also a very effective method of pain relief. In fact, post-operative hemorrhoid pain is usually most pronounced during the first week and becomes mild after seven days without the addition of any interventions. Together with our supplemental pain interventions with a variety of tools, we essentially ensure that the patient’s pain experience becomes minimal during and after surgery, thus substantially improving the patient’s quality of life and dignity of life. In addition, we would like to remind patients as well as their families about the post-discharge diet and care. Firstly, the diet should be easy to digest, and pay attention to the coarse and fine food, and forbid spicy and stimulating food. It is recommended to drink less tea, coffee, alcohol and other beverages to reduce the stimulation of the anal canal; secondly, actively prevent dry stools and keep the stools unobstructed to help speed up the healing of the wound; thirdly, avoid sitting and standing for a long time, and use warm salt water sitz bath appropriately after stool to achieve a better treatment effect. If you can do the above, you can not only reduce the postoperative pain, but also shorten the recovery period as much as possible, so that you can go back to your life and work in the fastest and best condition.