After years of dealing with stage three internal hemorrhoids, I did enough research to have surgery. I chose the THD (Transanal hemorrhoidal dearterialization) procedure and it was nearly painless so far. I couldn't be more thankful for a great surgeon. I hope this AMA can convince at least one person to get over their fears of surgery.

My Proof:

Comments: 110 • Responses: 44  • Date: 

exwasstalking15 karma

When did you know you had a problem? What made you decide that surgery was necessary?

nnopainnogainn20 karma

I went in to the ER with a small thrombosed one about 10 years ago. The situation slowly got worse. I didn't always have blood but eventually they had to always be manually "reduced" by pushing them back in. For years I was just wiping hemorrhoids. That gets old. Even though they're NOT cancer and do not become cancer, you can imagine the stress. I needed relief from that just as much as the medical side.

sadpandadude4 karma


having suffered for 4 years i am finding it pretty hard to cope. I was pretty much turned away from the docs 7 times, as I am an early 30's male in fairly good shape, so pretty much just advice of 'drink more water', 'change your diet', etc all of which I was doing anyways.

Its hugely stressful, always uncomfortable, can't really sit at all. Going to the bathroom is a nightmare.

How soon after surgery did you see improvement?

[deleted]1 karma


nnopainnogainn1 karma

Which version of this surgery? There are many

[deleted]1 karma


nnopainnogainn1 karma

I thought laser was painless too. I suppose not.

[deleted]1 karma


nnopainnogainn1 karma

That seems to be the biggest gamble with this surgery for people.

nnopainnogainn1 karma

Immediately! But you have to think of it from the perspective of what kind of relief as I had no pain prior.... but when I shit no "guests" are there to hang out. I thought it was going to be bad news in the OR....everything went perfectly. Only a 30 min surgery and I went home after.

itsjustvapor9 karma

Is it bad that I expected a before/after picture of your butthole as proof? oh internet...what have you done to me

nnopainnogainn4 karma

Honestly you couldn't even tell prior. In healing I have one that is protruding. Only pain I have. I imagine they ligated it which is why it hurts a little. I read many reviews that this was common and it would go away.

bluemitersaw9 karma

Can you give a layman's version of what the surgery was? Why did it take you ten years to decide to have it surgically resolved?

Hope you feel better and keep feeling better!

Edit: how --> hope

nnopainnogainn13 karma

The surgery uses Doppler to locate the arteries feeding the hemorrhoids. It runs multiple rounds of stitching around the artery and then drops down to the hemorrhoid. Once it's at the bottom of the hemorrhoid they basically tie it into a knot where the artery was and it lifts the hemorrhoids up higher. No actual cutting. This process returns the anatomy and cuts of the blood supply to the hemorrhoids. Super cool technology.

The wait was out of fear. Nothing more. Lots of horror stories on the internet mine was nothing like that at all

Psychh1 karma

Good call not getting them cut out. I had a hemorrhoidectomy last October and it still hasn't healed. I hope this is the end of your problems.

nnopainnogainn1 karma

What was your healing like? What stage were you? Internal?

Psychh1 karma

I'm not sure of the stage, but I had an internal one that I had to manually push back in, and two really bad external ones. The external ones had gotten worse and worse to the point where I had to take a week off of work before the surgery because of the pain. He took out the internal one while he was dealing with the external ones, since they're connected. The external ones were definitely the reason and the focus, though the removal of the inside has caused all of the issues afterwards.

The healing process was the most painful thing I've ever experienced, by far. I wouldn't wish it on anyone. The pain really was, as they say, like shitting out a cactus, for the first week or two at least. There was also constant leaking, so I had to have gauze taped in the area and changed throughout the day for a few months. The outside healed really quickly, but the inside has been causing issues ever since. i actually went back for a follow-up appointment, just to check things out, and he decided it would be a good idea to cut out MORE for some reason. That was half a year ago, and I still have bleeding after every bowel movement, with 1-4 pain most of the day. I'm going to see a specialist about it soon, hopefully the surgery parts are done with though...

nnopainnogainn2 karma

This is the wild part about this surgery; experiences vary.

I looked up reviews on EVERY doctor in my area that offered this. Then I looked at court records to see who was sued a lot. I picked the best. Turns out he had only done a dozen of these but he said only one had to come back for banding. I thought those were great odds. You can always see a new doc. My experience is to not mention what another doc thought as they tend to be swayed by another docs diagnosis.

Psychh1 karma

I definitely regret not seeing a specialist from the start. The one covered by my health insurance was on vacation at the time, so my doctor's office picked a general surgeon as the quickest option under my health plan.

nnopainnogainn1 karma

Technology has come so far. I'm sure a specialist would ease your fears.

one-hour-photo1 karma

Did you have any erectile dysfunction during the bad periods?

nnopainnogainn1 karma


roarbenitt8 karma

From what I understand from asking my doctor about mine basically they cut them open drain them out(They consist of mostly coagulated blood) and remove the clot that started it. I'm sure there is some pain killer involved as well.

That was half a year ago so I don't remember much about what he said. For all I know there might be different procedures depending on the doctor.

OP can feel free to correct me.

nnopainnogainn7 karma

There are many ways to do it. Traditionally they would cut them out. That's very old school and very painful. Newer solutions include rubber banding, PPH (stapling) and even laser!

Moscadilia8 karma

Was your bleeding bad? I've got them also but mines only the external one and isn't as large. My parents keep saying I'm too young to have them but I got them at around 20. Its not like I actively contracted it or anything. When did you have yours?

nnopainnogainn6 karma

Started at 25. Internal only. They can get worse. Just take care of it now and eat smart. Technology has come a long way and is on your side!

Moscadilia4 karma

I've already gotten a consult and I was told to watch my diet and just put it in if it hurts. I want it out but its still pretty small to have to undergo surgery. Was yours painful that's why you got it removed?

nnopainnogainn4 karma

I had zero pain. Maybe that's why it took so long to go for it? Sometimes if I stood for hours on end it would hurt. Mine were classified as "pretty large" by my doctor after he put a camera in my butt

Moscadilia4 karma

Ohhh wow. I guess the downside of it having it out is that it hurts but at least I won't need anything up my butt.

nnopainnogainn5 karma

If yours is small you can just have it banded. Takes mere minutes. You can walk out.

Moscadilia5 karma


nnopainnogainn6 karma

They put a rubber band around it. It dies and falls off.

youdontseekyoda8 karma

Supposedly, internal compression (think, butt-plug) helps reduce their size, and aids in treatment. Did you ever try anything like that, and if so, was it at all successful?

nnopainnogainn15 karma

I was terrible about all types of natural ways I could have helped them. I have never had a great diet and when Redbull hit the scene I was drinking three a day. Today, I'm much more mindful of what I put in my body. My bowel movements went from one a day to one every two days. That scared me and still needs to be worked on.

ent4rent7 karma

Activia, or some other yogurt. I ate it for about 2-4 weeks years ago and I've shit at the same time of day since

nnopainnogainn8 karma

I started fiber supplement and probiotics. Giving up coffee and caffeine too.

StinkinFinger9 karma

That's odd. Coffee is what keeps me regular.

I think a lot of people are getting hemorrhoids now because they sit on the can for too long reading their phones.

nnopainnogainn2 karma

Coffee is a diuretic but caffeine can cause dehydration and in turn constipation

DefectiveDetective12 karma

The volume of liquid in coffee outweighs the diuretic effects. Coffee is definitely not the best drink for re-hydrating, but it does not cause dehydration.

as_above_so_below0 karma

I drink 2-3 mocha's a day, large with 3 sugars. I poop in the morning and in the after noon. I also eat pretty bad but have a solid home cooked dinner at night.

nnopainnogainn1 karma

I can't imagine your insulin response to all that sugar is good. I was the same way. :/

AsRandomly7 karma

How does it feel to finally got rid of them?

nnopainnogainn12 karma

The mental relief is just as valuable. I was afraid of this surgery for years, I'm so thankful that recovery is nothing like I imagined.

homerunman5 karma

Can you give us some pooping advice now that you're wiser? I'm reading some of the comments and now I'm concerned about my habits.

nnopainnogainn7 karma

Eat more fiber. Drink more water. Don't force your poop

pmmeyourhairyvagina4 karma

Did you get to keep them in a jar after they were removed?

nnopainnogainn7 karma

They weren't removed, or I would have.

LanFeusT2311 karma

What does the procedure do if it doesn't remove then?

nnopainnogainn4 karma

Essentially it just lifts them higher and cuts off their blood supply.

ESNMRA174 karma

Hoe did it happen?

nnopainnogainn9 karma

Bad diet, genetics, sitting too long on the toilet. They can all contribute. The statistics on how many people suffer from them is surprising.

gutter_rat_serenade12 karma

When I was 11 I would lay down on the bathroom floor and jerk off because it was the only door with a lock on it.

My dad thought I was pooping and he told me that if I strained for that long I would give myself hemorrhoids.

I wish he would have warned me about the jerking off though, because now I'm blind.

nnopainnogainn4 karma

You're great with a keyboard at least

newredditsucks4 karma

I don't think he'll see either of these responses.

nnopainnogainn2 karma

I suppose there ARE worse things than butt problems

nnopainnogainn2 karma

You're great with a keyboard at least

Immortal_Azrael8 karma

I've heard that the design of modern toilets is largely responsible. Basically the human body isn't really meant to poop while in a sitting position and hemorrhoids are almost unheard of in countries where people still squat to poop.

nnopainnogainn7 karma

I've heard this as well. It doesn't help that modern tech has allowed us to go into the pooper with intentions other than pooping (eg Facebook, Instagram).

greffedufois7 karma

Get a small step stool or a squatypotty and don't allow your phone with you in the bathroom. I did this about a year and a half ago, and now my BMs take 2 minutes tops.

nnopainnogainn3 karma

Great advice. Anything longer than that and you're straining.

gutter_rat_serenade1 karma

I'll never understand how it takes more than just a couple minutes for someone to poop.

nnopainnogainn7 karma

Seriously, I WISH I pooped that quickly. The longer I take the more that comes out. It was a vicious cycle.

Fire_in_the_nuts4 karma

7-8 years ago, I underwent infrared photocoagulation for hemorrhoids. The doctor told me they'd be back in 2-3 years, and I'd need a "tune-up."

Sure enough, 3 years to the month, they were back. By that time, I'd developed Crohn's disease, and I figured he wouldn't work on someone with CD on top of hemorrhoids.

In desperation, I went back to trying something that had never worked for me: squatting. After reading up on it, I saw I had misinterpreted how to do it, and started doing it the "correct" way.

That was >4 years ago, and I've had only two tiny recurrences since- both in the days after having to use a "conventional" sit toilet.

In my case, squatting has definitely made a positive change in my lifestyle.

(Moreover, on a grain-free, low-carb diet, I have no symptoms from Crohn's disease, so I got that goin' for me.)

nnopainnogainn1 karma

That's great! I feel like I need to look into squatting now. What's an average days meal like for you?

Tosta_Mista4 karma

Might be a dumb question but when did you use to feel discomfort/pain? Just when you used the toilet or you could be in pain just by sitting? Was it something you always felt or there would be periods of time when you'd be ok? Thank you and have a good recovery =)

nnopainnogainn4 karma

Sitting too long would make them sore. Because they protruded, if I was constipated and had a tear it would take longer to heal. It was a nightmare for such an easy solution.

nicoekies1 karma

I entered this post expecting the top question to be: How did you get rid of them?...

nnopainnogainn1 karma


sadpandadude1 karma

Sufferer of the same for 4 years, actually had mine banded coming up to 2 weeks ago now. Still waiting for the little bastards to die and drop off though. Things have probably been worse for me since the op, hoping things get better in the next few days.

/u/nnopainnogainn can you describe how your op was different from banding? Have you had banding before, did it work?

nnopainnogainn1 karma

Based on my stage banding wouldn't have worked. Honestly for just having to take a few days off work the surgery isn't much more difficult than banding.

sadpandadude2 karma

Why would banding not have worked out of interest?

I had to have surgery and was put under even for banding. Even trying to examine was fairly excruciating, as apparently I also had a fissure that was causing problems.

They banded the actual roids, and injected them and the fissure with Botox which apparently would help.

Since then having a BM has been tricky, as trying not to strain, and venturing far from a 'friendly' toilet isn't ideal, eg going to work.

Was told within 7-14 days they would likely drop off, although my brain was a little muggy from the GA so can't remember exactly what they told me. Currently on day 12, but still not feeling great.

Apparently I will be going back to see someone in about 10 weeks, so if no joy, I will see what they say, but will hopefully be armed with the information of your procedure, as sounds like yours was fairly instant.

nnopainnogainn1 karma

The thing with banding is that its success rate is based upon reoccurance. I think if you're a grade two and beyond it's questionable as to whether or not it will serve you well. I saw two doctors and neither of them thought banding was an option. One offered PPH, the other THD. Right now I'm on laxatives and farts feel like poops so I head to the bathroom often. All temporary though

MASyndicate1 karma

I don't know if this is over, but here goes:

As a fellow person suffering from hemorroids, I've never been told that there is a surgery procedure that can heal it. Do you recommend it, or do you have any regrets of doing it? I am tired of having to sit on the shitter for a half an hour or even up to an hour sometimes, and keep pushing it back in so that blood won't splatter all over the bowel.

  1. Do you recommend performing the surgery, and what should I know about it before hand?

  2. Any tips for dealing with hemorroids?

Thanks in advance!

nnopainnogainn1 karma

Save yourself the agony. Go see a doc. THD is perfect for you and nearly painless!

DJKest1 karma

When you say "got rid of 'em" do you mean you are completely back to normal? Congratulations, that must feel really nice to finally be rid of such a chronic long-term problem.

nnopainnogainn1 karma

The surgery pulls them back inside so that I cannot even tell they exist

IamNotTheMama1 karma

Come back!

Mine come and go after BM`s (maybe 15-30 minutes) though they occasionally stick around for a week - the latter is quite debilitating.

I've suffered for 25+ years because of the previous horror stories.

Anyway, can you more completely describe the process as it applied to you?

nnopainnogainn2 karma

Mine became constant. The were at every bowel movement! Go see a specialist and change your life!

peart1 karma

I bet your ass is tired?

nnopainnogainn2 karma


Alex-Cross1 karma

Which dr did you go to? Is this a common procedure that can be done anywhere? Or is this procedure just offered by a few dr's?

nnopainnogainn1 karma

I saw a doctor in Phoenix. I've seen some people travel here for laser but my insurance didn't even cover laser. The doctor was Eugene Kim.

SuaveMF1 karma

A few questions please: (1) Have you tried other holistic remedies? It has been said that if you apply a 40/60 mixture of horseradish (German horseradish...has to be the German kind or it won't work) and peanut butter to the inflicted area that your hemorrhoids will disappear after a few weeks. Why didn'tchoo go this route instead of going through an expensive procedure? (2) Did your hemorrhoids ever itch bad? I had a pal who had super itchy hemorrhoids. One time so bad that he couldn't stop digging in deep and scratching himself through his jogging pants at the grocery store. I was laughing so hard I pissed myself in the store. (3) Did the procedure get rid of the hemorrhoids completely? (4) What do you think of the Moody Blues? (5) Wouldchoo wish hemorrhoids on your worst enemies? (6) How was the doctor able to precisely target the proper arteries? Did he have to shrink himself down to size and go in? (7) Were you able to sit right away after the procedure? How was your first dump after the procedure (8) At what age should we tell our kids to look for hemorrhoids? (9) List a good homemade meal recipe here that is genuine (not copied from the inner-webs). (10) Worst date you've ever been on? - Thanks!!

nnopainnogainn3 karma

Great post. 1) insurance covered it all so whyyyy not 2) mine never itched. Ever 3) 3 days post op. Gimme time 4) I used to dig em.... in the 90s 5) Totes Obvi 6) Doppler... and witch magic 7) 2 day pain block and laxatives saved my life 8) when they show up 9) chili paste and sesame seeds in top Ramen ftw 10) met a chick off pof that left mid date to go hook up with a recently released felon with no teeth. She may have been preggo too

StoneG-2 karma

For me, dropping Gluten from my diet allowed me to drop visits to my GI. After about three weeks, I was symptom free and never looked back.

Have you tried restricting your diet?

nnopainnogainn2 karma

I'm currently trying to be more mindful. Step 1. I know if I go too drastic I'll simply get discouraged.

StoneG-3 karma

So your not actually actively trying to fix the problem, instead you are trying to live with it and still carry on like nothings wrong. Got it.

How many surgeries are you intending to go through before you realize that something has to change? Also, who pays for your health care?

nnopainnogainn3 karma

If you read other posts I've noted changes I've made. Changes needed are more than diet.