Surgical and Non-Surgical Treatment of Anorectal Diseases

Published: 18.04.2025 · Last Updated: 05.08.2026 · Prepared by the Academic Hospital Web and Editorial Board.

The Hemorrhoid and Anorectal Diseases Unit takes on the diagnosis and treatment of all diseases of the anorectal region, which covers the anus and the final part of the rectum. The unit offers a broad range of treatment under one roof, from interventional procedures performed in the office setting to advanced surgical methods, and provides a specialist focused environment in which patients can seek care without embarrassment or discomfort.

Academic Hospital Hemorrhoid and Anorectal Diseases Unit

Contents

What Are Hemorrhoids and Anorectal Diseases?
Which Diseases and Conditions Are Treated?
When Should You Consult Us?
Diagnostic Methods
Treatment Approaches
Hemorrhoid and Anorectal Disease Treatment at Academic Hospital
Frequently Asked Questions
References

What Are Hemorrhoids and Anorectal Diseases?

Diseases of the anorectal region are extremely common in the population, yet they are an area where people consult a doctor late because of social reticence. This unit carries out the systematic assessment and individualised treatment of conditions such as internal and external hemorrhoids, anal fissure, anal fistula, anorectal abscess, fecal incontinence and rectal prolapse. The general surgery specialists and the team experienced in colorectal surgery determine the least invasive and most effective treatment route for each patient.

Which Diseases and Conditions Are Treated?

Internal hemorrhoids (grades 1 to 4)
External hemorrhoids and thrombosed (clotted) hemorrhoids
Mixed hemorrhoids (internal and external together)
Anal fissure (a tear on the inner surface of the anus)
Anal fistula (an abnormal tract arising from an anorectal abscess)
Anorectal abscess (a collection of pus in the anorectal region)
Fecal incontinence (inability to control bowel movements)
Rectal prolapse (protrusion of the rectal mucosa)
Condyloma acuminatum (warts in the anal region)

When Should You Consult Us?

Bright red blood on the toilet paper, in the toilet bowl or in the stool
Itching, burning or a moist sensation in the anal region
Pain during or after a bowel movement
Swelling or firmness felt around the anus
Involuntary loss of stool or inability to hold it
Discharge around the anus, or swelling together with fever or severe pain (suspected abscess)

Urgent consultation: Dark or bloody stool, unexplained weight loss or a marked change in bowel habit over recent weeks may signal a problem beyond the anorectal region; in this case urgent specialist assessment is required.

Diagnostic Methods

Method	Scope and use
Anorectal examination	The anorectal region is assessed clinically with inspection and digital rectal examination. Conditions such as external hemorrhoids, fissure and abscess can be detected directly.
Proctoscopy	The anal canal and the distal rectum are viewed directly with a short, rigid scope; the grade of internal hemorrhoids and the condition of the mucosa are assessed.
Colonoscopy	Performed to rule out an upper digestive origin of rectal bleeding and the presence of colorectal polyps or tumours, particularly in patients aged 45 and over.
MRI fistulography	The anatomical course of an anal fistula, its relationship with the sphincter muscle groups and the presence of an abscess are mapped in detail with radiation free MR imaging; it is of guiding importance in surgical planning.

Treatment Approaches

Non-Surgical (Office) Procedures

Procedure	Scope and application
Rubber band ligation	A small rubber band is placed on the internal hemorrhoid to cut off its blood supply; the tissue dries and falls away within a few days. It is the first choice method in grade 1 to 3 hemorrhoids.
Sclerotherapy	Sclerosing agents are injected into the hemorrhoidal tissue to obliterate the vessels; it is used particularly in small internal hemorrhoids with heavy bleeding.
Infrared coagulation and laser	Aims to shrink the hemorrhoidal tissue with infrared heat energy; it is a minimally invasive method.

Surgical Treatments

Operation	Scope and application
Hemorrhoidectomy	Surgical removal of the hemorrhoidal tissue in grade 3 and 4 disease or in hemorrhoids that do not respond to interventional treatment. It is performed with open or closed techniques (Milligan-Morgan, Ferguson).
Lateral internal sphincterotomy	Used in the treatment of chronic anal fissure to reduce the excessive pressure in the anal sphincter muscle.
Fistulotomy	In the treatment of simple anal fistulas that do not threaten the sphincter, the fistula tract is laid open and drainage is provided.
LIFT procedure (Ligation of Intersphincteric Fistula Tract)	A sphincter preserving technique in which the fistula tract is ligated in the intersphincteric space while the sphincter muscle is protected; it is used in complex anal fistulas.
Drainage of an anorectal abscess	Urgent surgical drainage is performed when an abscess forms; the development of a fistula is monitored after drainage.

The specialists of the General Surgery Department perform all of these procedures in a single centre, according to the individual indication.

Diagnosis, office procedures and surgical treatment of hemorrhoids and anorectal diseases are offered in a single centre at the Academic Hospital General Surgery clinic. Tel: 444 0 353

Book an Appointment

Hemorrhoid and Anorectal Disease Treatment at Academic Hospital

The Academic Hospital Hemorrhoid and Anorectal Diseases Unit carries out outpatient assessment, proctoscopic examination, office procedures and surgical treatment under one roof. The unit works routinely with the following departments:

General Surgery: performance of office procedures and anorectal operations
Gastroenterology and Coloproctology Surgery: surgical planning of complex fistula and rectal prolapse cases
Gastroenterology: differential diagnosis of rectal bleeding and assessment of inflammatory bowel disease
Endoscopy: performance of colonoscopy and rectoscopy
Radiology: mapping of the fistula tract with MRI fistulography
Gynecology and Obstetrics: joint decision making in the management of hemorrhoids during pregnancy
Nutrition and Diet: planning of a fibre based nutrition programme

Frequently Asked Questions

Is surgery always necessary to treat hemorrhoids?

No. The great majority of cases are managed successfully with dietary changes, topical treatments and office procedures such as rubber band ligation or sclerotherapy. Surgery is preferred in grade 3 and 4 disease or when interventional treatments do not produce a response.

Does an anal fistula heal on its own?

An anal fistula does not close spontaneously; on the contrary, it may follow a course of recurrent abscess attacks and chronic discharge. Its treatment is always surgical. The course of the fistula and its relationship with the sphincter are determined with MRI, and the most appropriate method is then chosen.

When can you return to work after hemorrhoid treatment?

After band ligation and sclerotherapy most patients go home the same day and resume daily life the next day. Recovery after surgical hemorrhoidectomy may take 1 to 2 weeks; those whose work requires heavy physical effort may need to wait 2 to 3 weeks.

How are hemorrhoids managed during pregnancy?

During pregnancy the first line approach consists of a fibre rich diet, adequate fluid intake, warm sitz baths and safe topical medication. Interventional procedures are usually postponed until after delivery. In thrombosed hemorrhoids or severe pain, the obstetrician and the surgeon decide together.

Is rectal bleeding always caused by hemorrhoids?

No. Colorectal polyps, inflammatory bowel disease and colon cancer can also cause rectal bleeding. Assessment with colonoscopy is essential, particularly over the age of 45, in people with a family history, or when bleeding is accompanied by weight loss or a change in bowel habit.

Can hemorrhoids be confused with colorectal cancer?

Both conditions can produce similar symptoms such as rectal bleeding, altered bowel movements and discomfort. For this reason, over the age of 50 or with a family history of colorectal cancer, bleeding should not be assumed to be hemorrhoids without consulting a physician. A definitive distinction is made with colonoscopy or rectoscopy; the Academic Hospital Gastroenterology and General Surgery departments carry out this assessment in coordination.

What are the dietary recommendations for hemorrhoids?

A fibre rich diet, plenty of water and regular exercise both relieve the symptoms of hemorrhoids and prevent them from recurring. Between 25 and 30 grams of fibre a day (wholegrain cereals, pulses, vegetables and fruit) and at least 8 glasses of water are recommended. Prolonged sitting, straining and alcohol consumption may worsen symptoms; dietitian support is arranged when needed.

Appointment and Information

444 0 353

Weekdays 08:00-18:00

Book an Appointment WhatsApp

References

The general information given on this page about the diagnosis of hemorrhoids and anorectal diseases, office procedures and surgical treatment options is supported by the reliable health sources listed below.

American Society of Colon and Rectal Surgeons, "Hemorrhoids: Expanded Information", fascrs.org
National Institute of Diabetes and Digestive and Kidney Diseases, "Hemorrhoids", niddk.nih.gov
Mayo Clinic, "Hemorrhoids: Diagnosis and Treatment", mayoclinic.org

The information on this page is for informational purposes only; it does not replace medical examination, diagnosis or treatment. Please consult a healthcare institution regarding your complaints.