Hemorrhoids can range from mildly uncomfortable to significantly disruptive. While many people experience manageable flare-ups that respond to at-home care, others develop more advanced cases — known as Grade III or Grade IV hemorrhoids — that cause ongoing pain, bleeding, or protrusion.
For those dealing with severe symptoms, surgery might seem like the only path forward. But that’s not always the case. Thanks to modern, minimally invasive techniques, many people find lasting relief without the need for a surgical procedure.
At Vessol Health, we believe in exploring every option — from lifestyle changes to non-surgical treatments — before considering surgery. Let’s look at what defines higher-grade hemorrhoids, why they develop, and which non-surgical treatments can help.
Understanding hemorrhoid grading
Doctors classify internal hemorrhoids using a grading system based on how far they protrude from the rectum and whether they return on their own:
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Grade I: Hemorrhoids bulge slightly into the rectum but stay inside.
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Grade II: They protrude during bowel movements but retract naturally.
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Grade III: They protrude and must be gently pushed back inside.
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Grade IV: They remain prolapsed (outside the anus) and cannot be pushed back in.
Grades III and IV are considered more advanced. They often cause frequent bleeding, visible lumps, irritation, and constant discomfort. Because these symptoms can interfere with daily life, many people seek professional treatment — but that doesn’t necessarily mean surgery.
Why surgery isn’t always the only answer
A hemorrhoidectomy — the surgical removal of hemorrhoids — can be highly effective, but it’s typically a last resort. Recovery can take weeks and may involve significant post-operative pain.
Fortunately, there are non-surgical procedures designed to shrink or close off hemorrhoids without the risks and downtime of surgery. These minimally invasive options target the source — blood flow and inflammation — allowing the hemorrhoid to shrink and symptoms to subside.
For many patients, these treatments provide lasting relief while preserving normal tissue and minimizing discomfort.
Minimally invasive treatments
Here are some of the most common and effective non-surgical treatments for Grade III and IV hemorrhoids:
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Rubber band ligation: A small rubber band is placed around the base of the hemorrhoid, cutting off blood supply so it shrinks and falls off naturally within 1–2 weeks.
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Sclerotherapy: A chemical solution is injected into the hemorrhoid, causing it to collapse, scar, and fade over time.
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Infrared coagulation (IRC): Gentle infrared light is used to coagulate blood vessels, shrinking the hemorrhoid tissue.
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Doppler-guided hemorrhoidal artery ligation: An ultrasound probe identifies blood vessels feeding the hemorrhoid, which are then tied off to reduce blood flow.
These procedures are typically performed in a doctor’s office or outpatient clinic. Most require minimal downtime, and patients can often return to regular activities within a day or two.
Lifestyle adjustments that support healing
Even with advanced treatment, lasting relief depends on addressing the root causes of hemorrhoids. Without lifestyle changes, symptoms can return.
Simple adjustments make a big difference:
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Eat more fiber. Fruits, vegetables, beans, and whole grains soften stools and reduce straining.
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Stay hydrated. Water allows fiber to do its job and keeps digestion smooth.
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Move regularly. Gentle exercise, such as walking or swimming, improves circulation and prevents blood from pooling in the rectal veins.
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Avoid sitting too long. Standing and stretching throughout the day helps relieve pelvic pressure.
These habits create the foundation for healing and help prevent recurrence after treatment.
What to expect from non-surgical care
Many people assume that severe hemorrhoids always require surgery — but that’s not true. Non-surgical treatments can be remarkably effective, especially for Grade III hemorrhoids, with success rates as high as 80% in some studies.
For Grade IV hemorrhoids, non-surgical methods may not fully eliminate the hemorrhoid but can still reduce pain, swelling, and bleeding, often delaying or avoiding surgery altogether. In many cases, combining a minimally invasive procedure with healthy daily habits offers long-term symptom control.
When surgery might still be necessary
While non-surgical treatments work for most people, some cases do require surgery. Very large, thrombosed, or strangulated hemorrhoids — where blood flow is cut off — may need surgical removal for full relief.
Your doctor may also recommend surgery if you experience severe bleeding or recurring flare-ups despite other treatments. Still, trying less invasive approaches first is usually worthwhile and often eliminates the need for surgery altogether.
The emotional side of severe hemorrhoids
Living with advanced hemorrhoids can take both a physical and emotional toll. Constant discomfort, itching, or bleeding can make daily activities feel daunting, and many people delay seeking help out of embarrassment.
It’s important to remember: you’re not alone, and there’s no shame in asking for treatment. Hemorrhoids are one of the most common medical conditions, and doctors treat them every day. Exploring non-surgical options isn’t just about avoiding surgery — it’s about reclaiming comfort, confidence, and normalcy.
Moving toward relief
If you’re struggling with Grade III or IV hemorrhoids, surgery isn’t your only option. Minimally invasive treatments like rubber band ligation, sclerotherapy, and artery ligation can provide substantial relief with minimal recovery time.
At Vessol Health, we take a whole-person approach — combining gentle procedural options with lifestyle guidance to help you find real, lasting comfort.
Hemorrhoids may be stubborn, but they’re treatable. With the right combination of expert care and everyday habits, relief is within reach — no surgery required.
