Chronic constipation is one of the most common causes of hemorrhoids, and many patients struggle with the question of whether they truly need surgery or if medication alone can treat the condition. To clarify this, we spoke with medical experts about the stages of hemorrhoids, the point at which they become severe, and when medicines are enough to provide relief.

Dr. Ananya Gupta, former head of the Gastroenterology Department at AIIMS Delhi, explains that hemorrhoids develop in four stages. Each stage requires a different approach, yet many patients assume surgery is the only solution. Some even fear that surgery may not work, but Dr. Gupta stresses that hemorrhoids are like any other medical condition—if diagnosed early and treated appropriately, they can be effectively managed.

When do medicines work, and when is surgery needed?

According to Dr. Gupta, hemorrhoids in stages 1 and 2 can usually be managed without surgery. The first line of treatment includes a high-fiber diet, increased water intake, steps to prevent constipation, and prescribed medications. If patients start treatment early, they typically experience significant improvement within a few months.

However, once hemorrhoids progress to stage 3 or 4, surgery often becomes unavoidable. At this point, the swelling increases, bleeding becomes frequent, and the pain intensifies. In such advanced cases, procedures like stapler hemorrhoidectomy or laser surgery are recommended to provide lasting relief.

Why do many patients end up needing surgery?

Dr. Gupta notes that most patients seek medical help only when the condition has already reached stage 3 or 4. Delayed treatment reduces the chances of relief through medication alone. This is why early detection is essential.

Anyone experiencing chronic constipation, needing to strain during bowel movements, or suffering from regular abdominal discomfort should consult a doctor promptly. Ignoring these symptoms can worsen the condition and eliminate the possibility of non-surgical treatment.