Hemorrhoids at 23, is surgery required

hello i am 23 years old and have had Hemorrhoids for a couple a years now, i have been to a doctor a few times and he has examined me and given lots of prescriptions including supposotries, cream etc but they do not work, he says i am to young for surgery and wants me to try the above medicines.

My question is this am i to young to have surgery and if i do does any one know how may doctors or nurses it involves as i am quite embarrsed, also i try to eat a high fibre diet but it still hurts when i relieve myself plz help.

Hi, I've recently had a hemorrhoidectomy at age 36. It is for a hemorrhoid I've had since I was your age actually.

Was your doctor a general practitioner or a colon specialist? I think most general practitioners will try to steer you away from the surgery because of the pain involved - it is one of the most painful recoveries that someone can go through. My doctor tried to persuade me against the surgery as well. However a colon specialist will most likely try to persuade you into surgery - always remember they have a vested interest financially.

I think your doctor is doing the father-figure thing and making the decision for you. I expect he is saying that he would not make the decision if he were in your shoes; however, that is not his job to make final decision. His job is to guide you into the "right" decision. In either case, he does not feel like you have considered your options carefully enough. You should voice your concerns that the decision is yours and for him to give you the information you need to make your own decision - and let him know that you are responsible enough to make your decision.

No you are not too young to have the surgery. But there is risk with all surgery. Anytime you are "put to sleep," there is the risk of death. It is unlikely, but it does happen. There is the risk of infection after surgery - which again has a risk of death...again unlikely, but infection is more likely. There are risks that your sphincter could be damaged and you could spend the rest of your life with stool seepage. There is risk of stinosis (I think that's how you spell it) where your sphincter grows shut. Overall, these are low risks and usually younger people recuperate from surgery quicker than older. But they are still risks. There is also the possibility of fissures which are usually more painful than hemorrhoids and some people develop other hemorrhoids during recovery. These are probably 2 of the more common outcomes. You can lessen some risks by making sure you do as you should during recovery.

Are you being open with your doctor about all the reasons why you are considering the surgery? After posting on a few health sites, it really surprises me how many people want the surgery because they are embarrassed by having a sexual partner see they have a hemorrhoid. Recognize this is not a "plastic surgery." You will have scars and around the scars you may have excess skin still (skin tags). This discussion (if it concerns you) needs to be had with a colon surgeon - not the general practitioner.

You'll have to see a specialist - so you'll go to a colon specialist (your surgeon), which shouldn't be too embarrassing since his office sees hem patients every day. They will know you'll be embarrassed, so they'll treat you very professionally. You will talk to the surgeon and some of his office staff - they will handle the insurance, setting up the hospital, etc.
For surgery, you'll have to go to the hospital for a pre-surgery testing and filling out paperwork. You'll have to see 1 or 2 people for paperwork, then you'll go with a nurse to get blood drawn.
You'll go back to the hospital for surgery. You'll meet with a prep-nurse that will help you get ready for surgery. Then you'll see the anesthesiologist (who will have called you before surgery). You'll be on a gurney and they'll roll you into a room. There will be a nurse or nurses to assist the surgeon in the operating room. You may or may not see them - you may be unconscious before they enter the room. You'll be on happy meds by then, so it's unlikely you'll care. After surgery, you'll have a post-surgery nurse that you'll wake up to. Someone will wheel you out of the hospital...could be the post-surgery nurse; may be someone different.

Hope this helps.

thank u for your reply but i just wanted to know that i think the piles i have are not that severe compared to most people so is it not possible for my g.p to perform the operation something about putting an elastic band or something around the pile and it coming off, also there must be some other minor operations to remove piles plz help also lol i am worried that the nurses will laugh if u have a quite hairy and not so toned bum. do u know of any people my age that i can talk to regarding this matter. thank you.

I've also had hemorrhoids since I was your age, and
had them removed at 46. One of them, an external one,
has recurred again, 3 or 4 years later.

Why should you be embarrassed, especially since you are a guy ?
Hemorrhoids must be one of the most common complaints seen
by doctors and nurses, whether outpatient or in the hospital.
And hemorrhoidectomies are one of the most common surgical
procedures performed. It's actually a minor surgical procedure,
though can result in some complications sometimes, and usually
painful recovery.

If you have first to second degree, and in some cases second
degree piles, they can be banded, especially internal ones -
that is, those above the dentate line (the line about one inch
inside the anus). Doctors, both general practitioners and
surgeons, prefer to band piles of this type, since those internal
ones above the dentate line are not painful.

If they are below the dentate line, that is external piles, or
internal piles which had prolapsed (or dangled) below this
line, they can still be banded, but this will be quite painful.
I've had piles of this type banded twice, and the pain and
discomfort was quite bad for one to two days, but bearable.
It's like some grabbing tightly your anus continuously. You
may also have trouble passing urine, since the muscles
controlling your bladder and urethra is quite near that area,
and may go into spasms.This is called urinary retention.

However, if the pile is too roundish, or confluential, to be
grabbed by a tight rubber band, then it can't be done, as
I was told is the case with my recurred hemorrhoid. Frankly,
I think it can still be banded, but all three surgeons whom
I went to won't band it this time, as they said the pain would
be excruciating, even though I told them I had gone thru it
before and can bear it. They told me it would have to be
excised again (sigh).

Go to see a surgeon to see if it can be banded. If not, ask
if he does other treatments, such as infrared coagulation,
or radiofrequency ablation.

If, however, your piles are bigger and more advanced, then
they usually be banded or treated with the other procedures.
Most 3rd degree, and all 4th degree piles, must be excised.

If the surgeon says surgery is required, select these three
instruments in the following order. I cannot post links to the
respective websites, or even links to Medline showing the
medical studies in which they were used, since the moderators
here do not allow it (which I think is quite silly), for fear of
"advertising or commercial motives" :

1. Starion instruments (thermal ligating shears)
2. Ligasure
3. Harmonic scalpel
4. Bipolar scissors (elecrically operated scissors)
5. Laser, especially the Nd-YAG type

If you search for them on Google, particularly the first two
devices, their websites will come out. After much research,
the Starion is my first choice, due to much reduced pain,
bleeding and compications like stenosis. Surgery with the
Ligasure device has been shown to be less painful than
even the harmonic scalpel, but has recorded a few cases
of stenosis (narrowing of the anus) in practice. The harmonic
scalpel is also quite a good device - almost no bleeding,
reduced pain and I can't find any cases of stenosis with it
on Medline. Pain, however, is a little more than the Starion,
which is actually quite new to the market.

If your surgeon does not use any of the above, he will very
likely have to resort to old-fashioned diathermy, or
electrocautery, which is basically an electric heating element,
much like a soldering iron ! It just cuts away the hemorrhoid
using heat. Pain, bleeding and stenosis will normally be much
more than the above devices.

It's unfortunate that the Starion device has only just been
introduced in Malaysia, and I am still hunting around for a
surgeon who uses it, or else this would my instrument of
choice on my next hemorrhoidectomy.

I'm also thinking about having hem surgery. I know every hospital and office is different, but how good are my chances that I can have a male nurse help me through my surgery?

I'm aware that female nurses are professionals and see that type of thing every day, but I would be much more comfortable with a male nurse. Is there a good possibility?

Although no relation between surgery and age, indications of surgery are very limited now. Generally speaking, first and second degree hemorrhoids almost always resolves with conservative measures, even many cases of third and fourth degree responds to conservative measures. Also, cases not responding to these measures should be tried first with non-operative procedures as rubber band ligation before surgery i.e. surgery is reserved to cases not responding to any other measures.

**edited by moderator**

I am suffering great pain due to piles inflammation. I was suggested to consult a hemorrhoid specialist. Anyone please help me if you do know any hemorrhoid specialist in Malaysia KL. Please. Seriously needing it.

I dont see what your age ahs to do with whether you should have the surgery or not. That logic makes no sense to me when your 23.

Ive had problems since I was about 20. I cant even remember what it was like to be "normal" anymore. Dealing with this takes a psycholical toll on you as the years go by and the problem becomes worse. Then as it becomes worse you become more afraid of doing anything about it, and its embaressing.

Im in the process of taking care of my trouble now at age 31. I let mine get very bad. So far I had one surgery to remove all the thrombosed tissue, and Im sure I will have to go in for a second procedure in the next couple of weeks, probably to have myself stapled.

Its not fun, theres a lot of pain involved, its complicated, you cant work for a while, but Im still happy Im taking care of all of this. Its worth it. Dont wait ten more years till your problem becomes as bad as mine did.