Hemorrhoids can cause discomfort, pain, itching, and bleeding, significantly impacting your daily activities and quality of life. At his practice in Orange County, CA, double board-certified colorectal surgeon Dr. Albert Chung provides effective, minimally invasive treatments and surgical options to relieve hemorrhoid symptoms. Schedule your consultation today by calling (714) 988-8690 for expert care and lasting relief.
Hemorrhoids are swollen, enlarged veins located in or around the anus and lower rectum. They're one of the most common conditions people deal with, and most cases are manageable with simple conservative treatments. When hemorrhoids significantly affect your comfort or quality of life, Dr. Chung offers comprehensive evaluation and the full spectrum of treatment options.
Hemorrhoids come in two main types, and the difference affects both symptoms and treatment.
Internal hemorrhoids are classified into four grades based on severity. Grading helps determine the most effective treatment approach.
Hemorrhoid symptoms vary based on type, location, and severity. Common signs include:
Severe cases may involve a thrombosed hemorrhoid, meaning a blood clot has formed within the hemorrhoid. This causes sudden intense pain and a firm lump near the anus. Prompt evaluation matters because treatment is most effective within the first 48 to 72 hours. While rectal bleeding is often due to hemorrhoids, it shouldn't be assumed. An evaluation ensures other causes are ruled out.
Several factors contribute to hemorrhoid development, often in combination.
During your consultation, Dr. Chung will review your symptoms and medical history and perform a gentle physical examination to determine the type, location, and severity of your hemorrhoids. This typically includes a visual exam and often an anoscopy, a quick in-office look inside the anal canal. In some cases, additional testing like colonoscopy may be recommended, especially if bleeding is a concern and there's any question about the source.
Many hemorrhoids respond well to non-surgical treatment and lifestyle modifications. Increasing dietary fiber, staying well hydrated, and avoiding straining during bowel movements are foundational. Sitz baths (soaking in warm water for 10 to 15 minutes), over-the-counter creams, and oral pain relievers can ease symptoms during flares. These approaches work for most Grade I and many Grade II hemorrhoids, and they help prevent recurrence after procedural treatment.
For persistent or more severe hemorrhoids, Dr. Chung offers the full range of minimally invasive and surgical treatments.
Dr. Chung also offers laser hemorrhoidoplasty (LHP) as an advanced minimally invasive option for Grade II and III internal hemorrhoids. For detail, see the laser treatment page.
Most hemorrhoids can be prevented or kept in check with everyday habits.
Recovery timelines vary based on the treatment. In-office procedures like rubber band ligation, sclerotherapy, and coagulation therapy typically involve minimal downtime, with most patients returning to normal activities within a day or two. Surgical treatments require more recovery time, which Dr. Chung will discuss specifically based on your situation. In all cases, you'll receive detailed aftercare instructions covering pain management, activity guidelines, bathroom habits, and follow-up timing.
Rubber band ligation (banding) is the workhorse of hemorrhoid treatment, and it is the procedure most Orange County patients end up having. A small elastic band is placed at the base of an internal hemorrhoid, above the dentate line where there are few pain nerves. The banded tissue loses its blood supply and falls away within five to ten days, and the remaining tissue scars down so the hemorrhoid no longer prolapses or bleeds.
The procedure takes a few minutes in the office, needs no sedation, and most patients drive themselves home. Dr. Chung usually bands one or two hemorrhoids per visit and spaces sessions a few weeks apart when more than one column needs treatment. Expect a feeling of pressure or fullness for a day or two, and use fiber, water, and sitz baths while the banded tissue separates. The American Society of Colon and Rectal Surgeons recommends banding as the first procedural option for Grade I to III internal hemorrhoids that have not responded to fiber and lifestyle changes. For a step-by-step walkthrough, read Rubber Band Ligation: What It Is and How It Works.
Patients often ask for hemorrhoid removal without knowing that the phrase covers several different procedures. Banding, infrared coagulation, and laser hemorrhoidoplasty shrink or scar the hemorrhoid in place. A hemorrhoidectomy physically removes the hemorrhoidal tissue. Which one you need depends on the grade of the hemorrhoid, whether it is internal or external, and how much it is affecting your life.
Hemorrhoidectomy remains the most definitive treatment, with the lowest recurrence rate of any option, and it is the right answer for Grade IV hemorrhoids, large external hemorrhoids, mixed internal and external disease, and patients who have failed office procedures. It is performed under anesthesia at a surgery center, takes under an hour, and involves the most recovery of any hemorrhoid procedure: most patients need one to two weeks before returning to desk work and two to four weeks before feeling normal. Dr. Chung uses a combination of long-acting local anesthetic, a structured pain plan, and personal post-op phone calls to keep that recovery manageable. Read What Is a Hemorrhoidectomy and What Should You Expect? and Hemorrhoid Surgery Recovery for detail.
Every option has a place. This is the framework Dr. Chung uses to match the treatment to the hemorrhoid.
| Treatment | Best for | Setting | Downtime | Recurrence |
|---|---|---|---|---|
| Fiber, water, sitz baths, creams | Grade I, mild Grade II, and every patient as a foundation | Home | None | Depends on habits |
| Rubber band ligation | Grade I to III internal hemorrhoids with bleeding or prolapse | Office, no sedation | 1 to 2 days of pressure | Low to moderate; can be repeated |
| Infrared coagulation | Small Grade I and II internal hemorrhoids | Office, no sedation | Minimal | Higher than banding |
| Laser hemorrhoidoplasty (LHP) | Grade II and III internal hemorrhoids when pain and fast recovery are priorities | Office or surgery center | Several days | Low to moderate |
| External thrombectomy | Painful clotted external hemorrhoid, within 72 hours | Office, local anesthetic | 1 to 3 days | Clot can recur |
| Hemorrhoidectomy | Grade IV, large external or mixed hemorrhoids, failed office treatment | Surgery center, anesthesia | 1 to 2 weeks to desk work | Lowest of all options |
External hemorrhoids behave differently from internal ones, and this is where a lot of frustration comes from. A swollen external hemorrhoid usually calms down within one to two weeks with sitz baths and stool softening. What often remains is a soft skin tag, which is stretched skin left behind after the swelling resolves. Skin tags are harmless, but they can trap moisture and stool, cause itching, and make cleaning difficult. Banding does not work on external hemorrhoids or skin tags because that skin is richly supplied with pain nerves. When an external hemorrhoid or tag keeps causing symptoms, Dr. Chung removes it with a short excision under local anesthetic in the office or as part of a hemorrhoidectomy. If a firm, painful lump appears suddenly, that is more likely a thrombosed external hemorrhoid, and it is best treated within the first 72 hours. Read What Is an External Hemorrhoid? and What Is a Hemorrhoid Skin Tag?.
The two are confused constantly because both cause bright red blood on the toilet paper. The pain pattern is the giveaway.
| Clue | Hemorrhoid | Anal fissure |
|---|---|---|
| Pain | Internal: usually painless. External: dull ache or throbbing, worse when swollen or thrombosed | Sharp, tearing pain during a bowel movement that can last minutes to hours afterward |
| Bleeding | Bright red, on paper or dripping in the bowl, often painless | Bright red streak on the stool or paper, paired with pain |
| What you feel | A soft lump or swelling, or tissue that pushes out and goes back in | Often nothing to feel, or a small skin tag at the edge of the anus |
| Trigger | Straining, pregnancy, long toilet sitting, heavy lifting | A hard or large stool, or chronic diarrhea |
| Treatment page | This page | Anal fissure treatment |
Looking for a hemorrhoid doctor in Orange County who offers every option under one roof? Dr. Chung is a fellowship-trained colorectal surgeon rather than a single-procedure hemorrhoid clinic, which means the recommendation you get is based on what your hemorrhoids need rather than on the one treatment a clinic happens to sell.
Dr. Chung sees patients at 30212 Tomas, Suite 365, Rancho Santa Margarita, CA 92688, off the 241 toll road in South Orange County. Patients come from Mission Viejo, Lake Forest, Irvine, Laguna Hills, Laguna Niguel, Aliso Viejo, San Juan Capistrano, Ladera Ranch, Trabuco Canyon, Santa Ana, and across Orange County. Most new patients are seen within days, and a first visit usually includes the exam, a plain-language explanation, and a treatment plan the same day.
Not ready for an in-person visit? Dr. Chung also offers online video consultations. Read what patients say on the reviews page.
A mild flare of internal or external hemorrhoids usually settles within one to two weeks with fiber, water, and sitz baths. A thrombosed external hemorrhoid can take two to three weeks to fully resolve on its own. Grade III and IV hemorrhoids do not heal by themselves and need a procedure. Read how long hemorrhoids last.
Yes. Banding and laser treat the hemorrhoids that exist, but new ones can form if straining, constipation, or long toilet sitting continues. Hemorrhoidectomy has the lowest recurrence rate of any treatment. Keeping stools soft and bathroom visits short is the most effective way to protect the result. See Can Hemorrhoids Grow Back?
See a colorectal specialist if bleeding lasts more than a week, if you have a painful lump, if hemorrhoids push out and do not go back in, if over-the-counter creams have not helped after two weeks, or if you are 45 or older and have never had a colonoscopy. Rectal bleeding should always be examined at least once so other causes can be ruled out. Read When Should You See a Doctor for Hemorrhoids?
There is no single best treatment. Grade I and II hemorrhoids usually respond to fiber and banding. Grade II and III hemorrhoids can be treated with banding or laser hemorrhoidoplasty. Grade IV and large external hemorrhoids need a hemorrhoidectomy. Dr. Chung examines you first, then recommends the least invasive option that will actually solve the problem. Read What Is the Best Treatment for Hemorrhoids?
Evaluation and medically necessary hemorrhoid procedures, including banding, thrombectomy, and hemorrhoidectomy, are generally covered by health insurance, subject to your deductible and copay. Coverage for laser hemorrhoidoplasty varies by plan. The office verifies your benefits before any procedure is scheduled so there are no surprises.
The swelling usually does, within one to two weeks. What can remain is a skin tag, which does not shrink further. If the lump is hard, very painful, and appeared suddenly, it is likely thrombosed and should be seen within 72 hours, when removing the clot gives the fastest relief.
Most hemorrhoids respond well to simple in-office treatment. Dr. Chung offers the full range of options, from conservative care to advanced procedures, and will help you find the approach that fits.
Book a consultation Call (714) 988-8690Most hemorrhoids heal within a few days to weeks with appropriate care. Severe or surgical cases may take slightly longer.
While treatments effectively relieve current symptoms, preventive measures are necessary to minimize recurrence risk. Dr. Chung provides guidance on lifestyle changes and preventive care.
Seek medical attention if hemorrhoid symptoms persist, worsen, or include significant bleeding, severe pain, or noticeable lumps.
Seek medical attention if hemorrhoid symptoms persist, worsen, or include significant bleeding, severe pain, or noticeable lumps.
Seek medical attention if hemorrhoid symptoms persist, worsen, or include significant bleeding, severe pain, or noticeable lumps.
Seek medical attention if hemorrhoid symptoms persist, worsen, or include significant bleeding, severe pain, or noticeable lumps.
Prompt diagnosis and treatment greatly improve colorectal cancer outcomes. Call Dr. Albert Chung’s colorectal clinic in Orange County.
