What are they? Hemorrhoids are swollen veins around the anal canal. hemorrhoids are located inside the anus but can sometimes protrude to the anal opening; bleeding is the major problem with these. hemorrhoids are located at the rim of the anus; these can also cause bleeding as well as itching and pain. Low tech solutions include lifestyle changes and topical therapies -- creams, ointments, suppositories etc. Surgery: One procedure is called rubber band ligation (RBL), in which a small band is placed around an internal hemorrhoid to cut off the blood supply. RBL is usually effective at least half of the time, and repeated ligations improve the success rate. Ligation causes minor pain for most people but no long-term side effects. Infrared photocoagulation (IPC), uses infrared light to heat and scar the hemorrhoid. Causes less pain, but may be less effective for more severe hemorrhoids. Hemorrhoidectomy might be considered, but this is appropriate only for a minority of people. Possible downsides are severe post-operative pain, urinary retention, and bleeding. Discuss the pros and cons with your doctor thoroughly before making your decision.