Before you consider surgery, make sure the bleeding is from hemorrhoids. If you are over age 40 and have not had a colonoscopy, ask your doctor if this should be done first.

Also, I assume you have tried measures that are more conservative.

If you do need a procedure for your hemorrhoids, the type of procedure will be determined by the size of the hemorrhoids and whether they are internal (inside the anus) or external (outside the anus).

If your hemorrhoids are not very large, and more internal than external, an office treatment called "rubber band ligation" may be an option. A rubber band is placed around the hemorrhoids. This strangles them and makes them shrink. Or your doctor may treat them by "infrared coagulation." An instrument uses heat to cauterize the hemorrhoids to make them shrink. These procedures do not completely get rid of the hemorrhoid right away, they just make it smaller. You will need two to four office treatments to get rid of all the hemorrhoids and reduce the chance of more coming back.

If you have large hemorrhoids, and especially hemorrhoids that are more external than internal, you may need regular hemorrhoidectomy surgery. This is not an office procedure.