Surgery should be considered when hemorrhoids are treated conservatively with poor results, recurrent attacks, and heavy symptoms that interfere with daily life. Specifically, surgery should be considered in the following cases. Internal hemorrhoids of degree III and IV with frequent attacks; embedded internal hemorrhoids; thrombosis; anemia due to heavy bleeding; ring hemorrhoids with significant downward sensation. If you are afraid of surgery, you should not continue conservative treatment. In the clinic, we often encounter severe anemia due to bleeding hemorrhoids, with hematocrit reaching 2-3g/l (above 12-13 in normal people), severe panic and shortness of breath, dizziness, and inability to engage in daily work and life, requiring blood transfusion before surgery, which is really a minor illness that has become a major one.