Eighty percent of patients who visit the anorectal surgery department come in because of hemorrhoids. Basically, everyone has hemorrhoids, which are a normal structure. Modern medicine refers to hemorrhoids as the “liner doctrine”, which is used to help close the anus. There’s a lot you don’t know about hemorrhoids. There are several types of hemorrhoids: medically speaking, hemorrhoids are a broad term, divided into internal, external, mixed, inflammatory, and thrombosed hemorrhoids, among others. External hemorrhoids have the most incidence, growing outside the anus, and are usually inflamed or painful before people come to the doctor. The clinical manifestation of internal hemorrhoids is bleeding, which is divided into three degrees: the first degree is bleeding, the second degree is prolapse, and the third degree is prolapse out of the body must be sent back by hand. This is called a third stage internal hemorrhoid in China, and is generally divided into four degrees abroad. Mixed hemorrhoids are, as the name implies, “both inside and outside”. The treatment is different from the first two and is more complicated. Internal hemorrhoids can be treated with injection therapy. Internal hemorrhoids used to be considered the most difficult to treat, but now, they are the easiest – injection therapy is used all over the world. There are two types of injection therapy; one injects a necrotizing agent, a drug that allows the hemorrhoid to gradually necrotize and fall off again, which in turn leads to treatment. The side effects are more painful, easy post-operative bleeding and anal stenosis, and a somewhat longer course of disease. In the last 20 years, another method, herbal treatment, has been mostly used in China. This is a kind of sclerotherapy, in which the active ingredients of Chinese medicine are extracted and made into an injection to make the local blood vessels contract and then atrophy. This is often referred to as minimally invasive therapy, which is basically non-invasive, less painful and shorter in duration. In case of early simple internal hemorrhoids, as long as they are within the first, second or third degree, they can be completely solved with the above method. The recovery process can be cured quickly with the use of some suppositories – laxative medications that help with bowel movements. External hemorrhoids are best treated with minimally invasive surgery. Many people have external hemorrhoids, which are called external hemorrhoids when a local wrinkled skin muscle forms, but many people have asymptomatic external hemorrhoids, which often do not get enough attention. External hemorrhoids need to be surgically removed. I have encountered many patients who have suggested that they would like to use an application of medication and not have surgery. I do not advocate this! It is too much local damage to the anus and causes more sequelae. Personally, I believe that a good treatment should, firstly, relieve the pain; secondly, there should be no sequelae and ensure the normal function of the anus, and then the quality of the surgery. Minimally invasive surgery is very desirable, which can not only reduce the patient’s pain, but also shorten the treatment and reduce the cost. These three aspects are important indicators for judging whether the treatment plan is good or bad. It is a misconception that having hemorrhoid surgery can be very painful. With the development of medicine, the treatment methods are now very reasonable, the pain is minimal, and the time is much shorter. For example, copper ions, injections, and topical fumigation can improve hemorrhoid symptoms, but of course, if your hemorrhoids are so bad that they have prolapsed, you must go to the hospital for surgical treatment, which means injection therapy and surgical removal. The various hemorrhoid suppositories advertised only provide relief, not a cure! Hemorrhoid suppositories can improve or relieve symptoms, they do not eradicate hemorrhoids. If you do get the disease, you should still go to a specialist hospital for examination and treatment. I am available every Tuesday morning at Guang’anmen Hospital, all day Wednesday at St. Mark’s Hospital, and Monday and Thursday mornings at Fengtai Right Anmen Hospital in Beijing. If you or a family member is experiencing any of these problems, feel free to come see me for a chat. The only way to eradicate hemorrhoids is surgery, it just varies in approach depending on the condition. It would be a lie to say that there is no damage at all. Many patients are afraid of surgery and reluctant to have it, in large part due to fear of pain. In fact, as long as the treatment method is chosen wisely, what method is used for what disease, you can minimize the pain. For example, for heavier circumferential mixed hemorrhoids, small incisions and multiple incisions, both so-called minimally invasive surgery, can be chosen. Surgery is only one part of the treatment method; it is the post-operative medication changes and recovery treatment that are most important. After surgery, you can use a combination of Chinese and Western medicine, taking some laxative herbs orally and applying herbal ointments, such as Yu Hong Ointment and Si Huang Ointment, to relieve pain and help recovery. You can also use herbal sitz baths that invigorate blood circulation and relieve pain.