Dr. Hibberd's answer:

 

Hemorrhoids are nothing more than varicose veins of your bottom end. They produce little more than itching or discomfort, and only very rarely do they result in painful clot formation that require more aggressive attention for relief of the acute pain.

 

They often appear after pregnancy or after bowel prep agents. They can also be brought on by prolonged straining while using the bathroom, low fiber diets, and in some cases liver disease or hypertension. Most of the time, intermittent symptoms are no cause for concern. But persistant or repeated symptomatic recurrences may justify local procedures such as banding or laser ablation.

 

Only rarely is a major procedure — such as surgery — recommended. Surgery is almost always an event of last recourse for most patients, but in the end it often becomes a matter of your individual choice.