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Hemorrhoid Care
Hemorrhoids Specialists at Surgical Associates of Southern Texas
Hemorrhoid Evaluation, Office Procedures & Surgery
Itching, a tender lump near the anus, pain with bowel movements, or bright red blood on the toilet paper are common signs of hemorrhoids. Most flare-ups settle within one to two weeks with fiber, fluids, and over-the-counter or prescription treatment, but rectal bleeding should always be checked, and hemorrhoids that keep returning may need a procedure.
At Surgical Associates of Southern Texas, board-certified surgeon Dr. Murtaza Shakir examines the area, confirms whether hemorrhoids are the cause of your symptoms, and recommends the simplest treatment likely to work, from home care and office procedures to surgery when it is needed. He sees patients at offices in Katy and Sugar Land, serving Richmond, Fulshear, Stafford, Fort Bend County, and Greater Houston.
Meet the Surgeon
Dr. Murtaza Shakir, MD, general surgeon treating hemorrhoids in Katy and Sugar Land, TX
- Dual board certified in General Surgery and Complex General Surgical Oncology
- Named a Houstonia Top Doctor in General Surgery, 2026 (see listing)
- Highly reviewed: rated 4.9 stars on Google
- Specialized in hemorrhoid procedures and surgery, hernia repair, gallbladder surgery, and colorectal surgical oncology
Patient Reviews
What Patients Say About Dr. Shakir
Rated 4.9 stars on Google. Real experiences from patients treated in Katy and Sugar Land.
Jump to a section
- At a glance
- What are hemorrhoids?
- Internal, external, and thrombosed
- Symptoms and when to see a surgeon
- How hemorrhoids are diagnosed
- Home treatment
- Do hemorrhoids need surgery?
- Meet your surgeon
- How treatment is chosen
- Office procedures vs. surgery
- Procedure details
- Before your procedure
- Recovery
- Risks and complications
- Patient reviews
- Why choose us
- Insurance
- Locations
- FAQs
- Schedule a consultation
At a Glance
Hemorrhoids at a Glance
- What they are
- Swollen veins inside the lower rectum (internal) or under the skin around the anus (external). They are also called piles.
- How common
- About 1 in 20 Americans have hemorrhoids, and they become more common after age 50.
- Common symptoms
- Bright red blood with bowel movements, itching, a tender lump near the anus, pain when sitting or passing stool, or tissue that bulges out of the anus.
- First-line care
- Fiber, plenty of fluids, no straining, warm sitz baths, and short-term creams or suppositories. Most flare-ups improve within one to two weeks.
- When a procedure helps
- Hemorrhoids that keep bleeding, prolapse, or return despite home care. Fewer than 1 in 10 patients need surgery.
- Who treats them
- A general surgeon. Dr. Shakir is board certified in General Surgery and Complex General Surgical Oncology.
- Urgent warning signs
- Heavy rectal bleeding, dizziness or fainting, black or maroon stools, severe anal pain, or fever. Call 911 or go to the nearest emergency department.
- Where
- Offices in Katy and Sugar Land, TX. Call 713-955-9191.
Hemorrhoid Basics
What Are Hemorrhoids?
Hemorrhoids, often called piles, are swollen veins in the lower rectum or around the anus. Everyone has hemorrhoidal tissue; it becomes a problem when the veins stretch, swell, bleed, or slip out of place.
Hemorrhoids are common. About 1 in 20 Americans have them, and the chance rises after age 50. They are uncomfortable, but they are not dangerous in themselves and do not turn into cancer.
Who Gets Hemorrhoids?
Anyone can develop hemorrhoids. You are more likely to get them if you:
- Strain during bowel movements
- Sit on the toilet for long periods
- Have chronic constipation or diarrhea
- Eat a low-fiber diet
- Are pregnant
- Have obesity
- Lift heavy objects often
The tissues that support the anus and rectum also weaken with age, which is one reason hemorrhoids become more common later in life.
Hemorrhoid Types
Internal, External, and Thrombosed Hemorrhoids
Hemorrhoids are named by where the swollen veins develop, and the type largely determines your symptoms and treatment. Many people have more than one type at the same time.
How Internal Hemorrhoids Are Graded
Surgeons grade internal hemorrhoids by how far they prolapse, which helps guide treatment:
- Grade I: bleed but do not prolapse
- Grade II: prolapse with bowel movements and go back in on their own
- Grade III: prolapse and must be pushed back in by hand
- Grade IV: stay outside the anus and cannot be pushed back
Lower grades usually respond to home care or an office procedure; higher grades are more likely to need surgery.
Internal Hemorrhoids
Internal hemorrhoids form in the lining of the lower rectum, where there are few pain nerves, so they are usually painless. The most common sign is bright red blood on the stool, the toilet paper, or in the bowl.
Prolapsed Hemorrhoids
Straining can push an internal hemorrhoid down through the anus, where it forms a bulge. Some go back in on their own, some must be gently pushed back, and some stay out. Prolapsed hemorrhoids can ache, itch, and leave mucus on underwear.
External Hemorrhoids
External hemorrhoids form under the skin around the anus and look like small lumps. Because this skin is sensitive, they often cause itching, burning, or pain, especially when sitting or when irritated by wiping.
Thrombosed Hemorrhoids
When a blood clot forms inside an external hemorrhoid, it becomes a thrombosed hemorrhoid: a firm, painful, bluish lump that appears suddenly. The pain is usually worst in the first few days and then eases as the body absorbs the clot.
Hemorrhoid Symptoms
What Are the Symptoms of Hemorrhoids?
The most common hemorrhoid symptoms are painless bright red bleeding with bowel movements, anal itching, and a lump or swelling near the anus. Symptoms vary with the type and severity of the hemorrhoids:
- Bright red blood on the toilet paper, on the stool, or in the toilet bowl
- Itching or irritation around the anus
- Pain or discomfort during bowel movements
- One or more tender lumps or swelling near the anus
- Aching or pain in the anal area, especially when sitting
- Tissue that bulges out of the anus after a bowel movement
- Mucus leakage or difficulty keeping the area clean
Not every anal symptom is caused by hemorrhoids. Anal fissures, abscesses, fistulas, skin conditions, polyps, and colorectal cancer can cause similar complaints, which is why an examination matters.
When to See a Surgeon for Hemorrhoids
Schedule an evaluation if you have:
- Any rectal bleeding that has not been evaluated
- Symptoms that do not improve after about a week of home treatment
- Hemorrhoids that keep coming back
- A hemorrhoid that prolapses or must be pushed back in
- A painful lump near the anus
- Ongoing bleeding, itching, or soiling that affects daily life
Rectal bleeding should never be assumed to be from hemorrhoids. It can also be a sign of inflammatory bowel disease or cancer of the colon or rectum, so it needs a medical evaluation. Learn the signs and symptoms of colon cancer.
When Rectal Bleeding or Anal Pain Needs Urgent Care
Most hemorrhoid bleeding is light. Seek care right away for heavy or continuous bleeding or clots, dizziness or fainting with bleeding, black or maroon stools, severe or worsening anal pain, fever or chills with swelling, or bleeding with abdominal pain or diarrhea. For a medical emergency, call 911 or go to the nearest emergency department.
Diagnosis
How Are Hemorrhoids Diagnosed?
Hemorrhoids are diagnosed with a conversation about your symptoms and a brief examination of the anal area. Dr. Shakir asks about bleeding, pain, prolapse, bowel habits, previous treatment, and your family history of colon or rectal cancer. The exam is done privately and usually takes only a few minutes.
Visual and Digital Rectal Exam
External hemorrhoids, thrombosed hemorrhoids, and prolapsed tissue can often be seen on inspection. A gloved, lubricated finger then checks the lower rectum for tenderness, masses, or other problems.
Anoscopy
Internal hemorrhoids usually cannot be felt. An anoscope, a short, lighted tube inserted a few inches into the anus, lets the surgeon see the internal hemorrhoids, grade them, and look for other causes of bleeding such as a fissure.
Colonoscopy When Indicated
Because bleeding can also come from higher in the colon, Dr. Shakir may recommend a colonoscopy. This is especially likely if you are 45 or older and not up to date on colorectal cancer screening, have a family history of colorectal cancer, have dark or mixed-in blood, a change in bowel habits, unexplained weight loss, anemia, or bleeding that does not fit the exam findings. If an abnormality is found, our colon cancer care is part of the same practice.
Please bring a list of your medications, especially blood thinners, and any recent colonoscopy reports to your visit.
Conservative Care
How Are Hemorrhoids Treated Without a Procedure?
Most hemorrhoids improve with home care that softens the stool and reduces straining. Flare-ups commonly settle within one to two weeks of over-the-counter or prescription treatment, and the same habits lower the chance of hemorrhoids coming back.
Fiber
Eat more fruits, vegetables, beans, and whole grains, and consider a fiber supplement such as psyllium or methylcellulose. Increase fiber gradually to limit gas and bloating. A stool softener may also help.
Fluids
Drink plenty of water and other non-alcoholic fluids each day, as your doctor recommends. Fiber works best when you are well hydrated.
Better Bathroom Habits
Go when you feel the urge, avoid straining or holding your breath, and do not sit on the toilet for long periods, including while using a phone. Avoid frequent heavy lifting during a flare.
Sitz Baths
Soaking the anal area in a few inches of warm water for 10 to 15 minutes, several times a day and after bowel movements, can ease pain, itching, and muscle spasm.
Creams and Suppositories
Over-the-counter creams, ointments, pads, and suppositories, such as those containing hydrocortisone, witch hazel, or a numbing medicine, may ease mild pain, swelling, and itching. Doctors generally recommend them for about one week; follow up if symptoms persist or the skin becomes irritated.
Pain Relief and Gentle Care
Over-the-counter pain relievers can help, unless your doctor has told you to avoid them. Clean the area gently with water or unscented wipes rather than rubbing with dry toilet paper.
Timing of Treatment
Do Hemorrhoids Need Surgery?
Usually not. Fewer than 1 in 10 people with hemorrhoids need surgery; most improve with home care or a quick office procedure. Surgery becomes an option when hemorrhoids are large, keep prolapsing, keep bleeding, or keep returning despite other treatment.
Problems are more likely when a flare is not followed by good aftercare, such as continued fiber, fluids, and avoiding straining. Two situations in particular often lead to a procedure:
- Thrombosed hemorrhoids: a painful blood clot develops in an external hemorrhoid.
- Prolapsed hemorrhoids: internal hemorrhoids drop through the anus and form a bulge that may not stay in.
Signs a Procedure May Be the Next Step
- Bleeding that continues after several weeks of good home care
- Internal hemorrhoids that prolapse and must be pushed back in, or will not go back in
- Large external hemorrhoids or repeated thrombosed hemorrhoids
- Hemorrhoids that return after an office procedure
- Symptoms that interfere with work, sitting, exercise, or hygiene
Your Surgeon
Meet Your Hemorrhoid Surgeon
Murtaza Shakir, MD
Board-Certified General Surgeon & Surgical Oncologist
Hemorrhoid care at Surgical Associates of Southern Texas is led by Dr. Murtaza Shakir, who is board certified in General Surgery and Complex General Surgical Oncology.
Board certification
American Board of Surgery: General Surgery and Complex General Surgical Oncology
Medical degree
Aga Khan University
Residency
General Surgery, Riverside Methodist Hospital, Columbus, Ohio
Fellowship
Two-year Surgical Oncology fellowship, University of Pittsburgh Medical Center
Surgical practice includes
Named a Houstonia Top Doctor in General Surgery (2026). Learn more about our general surgery services.
Treatment Planning
How Dr. Shakir Chooses the Right Hemorrhoid Treatment
The goal is the least invasive treatment that will control your symptoms. Dr. Shakir and the team at Surgical Associates of Southern Texas decide the plan with you after weighing these factors.
Internal, External, or Both
Office procedures treat internal hemorrhoids. External hemorrhoids, and combined internal and external disease, are more often managed with home care or surgical removal.
Grade and Size
Grade I and II internal hemorrhoids often respond to banding or other office treatment. Larger grade III and IV hemorrhoids are more likely to need surgery.
Your Main Symptom
Bleeding, prolapse, pain, itching, and soiling each point toward different treatments. A painful clot is handled differently from painless bleeding.
What You Have Already Tried
How well fiber, fluids, and medication have worked, and whether earlier office procedures helped, guides the next step.
Other Causes Ruled Out
Bleeding must be explained before treatment. A fissure, polyp, or other finding can change the plan, and a colonoscopy may come first.
Your Overall Health
Blood thinners, bleeding disorders, pregnancy, bowel conditions, and your ability to have anesthesia all affect which treatment is safest.
Comparing Options
Office Procedures vs. Hemorrhoid Surgery
Hemorrhoid procedures fall into two groups: office-based treatments done without anesthesia, and surgical procedures done with anesthesia. Office procedures are quicker to recover from; surgery is more thorough and is used for larger or persistent hemorrhoids.
Procedures Without Anesthesia
- Options: rubber band ligation (banding), sclerotherapy, and coagulation therapy
- Best for: internal hemorrhoids, especially grades I to III, that bleed or prolapse
- Setting: usually done in the office in a few minutes
- What you feel: pressure or mild discomfort, not sharp pain
- Recovery: most people return to normal activities within a day or two
- Trade-off: more than one session may be needed, and hemorrhoids can return
Procedures With Anesthesia
- Options: hemorrhoidectomy, hemorrhoidopexy (stapled procedure), and hemorrhoidal artery ligation, including transanal hemorrhoidal dearterialization (THD)
- Best for: large, prolapsing, or combined internal and external hemorrhoids, and hemorrhoids that return after office treatment
- Setting: outpatient surgery, usually with same-day discharge
- What you feel: nothing during the procedure; soreness afterward
- Recovery: about one to three weeks, depending on the procedure
- Trade-off: more discomfort and recovery time, with a lower chance of recurrence after hemorrhoidectomy
The treatment plan depends on the patient and is decided together with the team at Surgical Associates of Southern Texas. Ask about pain management options at your consultation.
Procedure Details
Hemorrhoid Procedures and Surgery Explained
Each procedure works differently: some shrink or cut off blood flow to the hemorrhoid, while others remove or reposition the tissue. Here is what each involves.
Rubber Band Ligation (Banding)
A small rubber band is placed around the base of an internal hemorrhoid, above the area that feels pain, to cut off its blood supply. The hemorrhoid shrinks and falls off, usually within about a week, often unnoticed with a bowel movement. One or two hemorrhoids may be treated per visit, so several sessions may be needed.
Sclerotherapy and Coagulation Therapy
Sclerotherapy injects a solution into an internal hemorrhoid; coagulation therapy uses infrared light, heat, or an electric current. Both create scar tissue that shrinks the hemorrhoid and cuts off its blood supply. They are used for smaller internal hemorrhoids and are not used for external hemorrhoids.
Hemorrhoidal Artery Ligation and THD
Hemorrhoidal artery ligation closes off the small arteries that feed the hemorrhoids. In transanal hemorrhoidal dearterialization (THD), a Doppler ultrasound probe inside a special proctoscope locates these arteries, which are then tied off with stitches. Prolapsing tissue can also be lifted back into place with stitches. No tissue is cut away, so many patients have less pain than after hemorrhoidectomy, although hemorrhoids are more likely to return than after excision.
Hemorrhoidectomy
Hemorrhoidectomy is the most complete treatment and removes both internal and external hemorrhoid tissue. The blood vessel feeding the hemorrhoid is tied off with a tight stitch to control bleeding, and the excess tissue is then removed. The wound may be closed with dissolvable stitches, and an absorbent pack may be placed inside the rectum to help prevent bleeding; it stays in place until your first bowel movement after surgery. The operation typically takes 30 minutes to one hour, depending on the severity and complexity of the case.
Hemorrhoidopexy (Stapled Procedure)
In a stapled hemorrhoidopexy, a circular stapling device removes a ring of tissue above the hemorrhoids and lifts prolapsing internal hemorrhoids back into their normal position, reducing their blood supply. It is generally less painful than hemorrhoidectomy but is not used for external hemorrhoids, and hemorrhoids are more likely to return.
Treating a Thrombosed Hemorrhoid
A thrombosed hemorrhoid often improves on its own over several days with sitz baths, pain relievers, and stool softeners, and the lump shrinks over a few weeks. When the pain is severe, especially in the first few days, a surgeon may remove the clot or the hemorrhoid through a small incision under local anesthesia for faster relief. Repeated clots are one reason to consider hemorrhoidectomy.
Preparing for Surgery
Before Hemorrhoid Surgery
Preparation is simple for most patients and is reviewed at your consultation. Hemorrhoid surgery can usually be completed in a single day, so you can recover at home. Surgery can feel intimidating, but the surgical team supports you before, during, and after the procedure, and you are not discharged until you are comfortable.
What Preparation May Include
- Consultation and examination
- Colonoscopy first, when indicated
- Review of medical history and medications
- Preoperative testing when needed
- Anesthesia evaluation for surgical procedures
- Instructions on eating, drinking, and any bowel preparation
- A ride home after anesthesia
See our pre-operative care guidance.
What to Tell the Surgical Team
- Blood thinners and aspirin
- All prescription and over-the-counter medicines
- Supplements
- Bleeding problems
- Diabetes, heart, or lung conditions
- Pregnancy or possible pregnancy
- Previous anal or rectal surgery
- Allergies
Do not stop prescription medication unless instructed by the appropriate healthcare professional.
After Treatment
Hemorrhoid Surgery Recovery Time
After hemorrhoid surgery, you may have discomfort for up to about three weeks; after an office procedure, most people are back to normal within a day or two. Recovery depends on the procedure, how much tissue was treated, and your own healing.
- Pain control: take pain medication as prescribed by your surgeon, and use warm sitz baths several times a day.
- Bowel movements: keep stools soft with fiber, fluids, and a stool softener as directed; avoid straining. The first bowel movements after surgery are often the most uncomfortable.
- Time off work: after hemorrhoidectomy, your surgeon may advise about two weeks off work; after banding, many people return the next day.
- Activity: light exercise such as walking can help relieve pain and is encouraged. Avoid heavy lifting until cleared.
- Expected effects: a small amount of bleeding or drainage, especially with bowel movements, is common in the first weeks.
For more detail, see our post-operative care instructions, pain management, and Enhanced Recovery After Surgery (ERAS) pages.
When to Call After Treatment
Call the office if you have increasing pain, bleeding that does not slow down, no bowel movement for three days despite stool softeners, or swelling or drainage that worsens. Call 911 or go to the nearest emergency department for heavy bleeding, fainting, fever with severe pain, or inability to urinate.
Keeping Hemorrhoids From Coming Back
A high-fiber diet, plenty of fluids, and not straining or sitting on the toilet for long periods remain the best protection after any treatment. These habits help reduce pain during bowel movements and the risk of future flare-ups.
Treatment Risks
Risks and Possible Complications of Hemorrhoid Treatment
Hemorrhoid treatment is common and generally safe, but every procedure carries some risk, such as pain, bleeding, trouble urinating, infection or hemorrhoids returning. Schedule a consultation and Dr. Shakir will explain the risks that apply to you.
Why Choose Us
Why Choose Surgical Associates of Southern Texas for Hemorrhoid Care?
Dr. Murtaza Shakir is board certified in General Surgery and Complex General Surgical Oncology and treats hemorrhoids with private, respectful care at offices in Katy and Sugar Land.
- Rectal bleeding is evaluated, not assumed to be hemorrhoids
- Least invasive option first, surgery only when needed
- Treatments from office banding to hemorrhoidectomy
- Brief, private exams explained in plain language
- Consultations in Katy and Sugar Land
Insurance Coverage
Insurance for Hemorrhoid Treatment
Surgical Associates of Southern Texas accepts many major insurance plans for hemorrhoid evaluation, office procedures, and surgery, including participating Aetna, Cigna, UnitedHealthcare, and Blue Cross Blue Shield plans. Our office can confirm whether your specific plan participates and whether a referral or prior authorization is needed before your visit.
Coverage, network participation, authorization requirements, and your share of the cost vary by plan. You can also review the insurance accepted for surgical care at our practice.
Aetna, Cigna, UnitedHealthcare, and Blue Cross Blue Shield are only some of the plans we accept. Plan-specific details are on our Aetna, Cigna, UnitedHealthcare, and Blue Cross Blue Shield pages. If your plan is not listed, contact our office and our team will help verify it.
Insurance participation and benefits vary by individual plan. Verification does not guarantee coverage, authorization or payment. Please contact our office and your insurer to verify benefits before treatment.
Our Locations
Two Convenient Fort Bend County Offices
Learn more about our Katy and Sugar Land practices, or view all locations.
Katy Office
410 W Grand Pkwy S, Suite 4D
Katy, TX 77494
Serves: Katy, Fulshear, Richmond, Cinco Ranch and West Houston
Sugar Land Office
17510 W Grand Pkwy S, Suite 320
Sugar Land, TX 77479
Serves: Sugar Land, Richmond, Stafford, Missouri City, Fort Bend County and Southwest Houston
Approximate Drive Times
From West Houston (Energy Corridor): about 15 minutes to Katy, or 25 to 30 minutes to Sugar Land.
From North Houston: about 40 to 50 minutes to either office, depending on traffic.
Common Questions
Frequently Asked Questions About Hemorrhoids
How long do hemorrhoids take to go away?
Most hemorrhoid flare-ups improve within one to two weeks with fiber, fluids, and over-the-counter or prescription treatment. A thrombosed hemorrhoid is usually most painful for the first few days, and the lump may take several weeks to shrink.
Is bleeding from hemorrhoids dangerous?
Hemorrhoid bleeding is usually light and bright red, but rectal bleeding can also come from inflammatory bowel disease or colon or rectal cancer. Any rectal bleeding should be evaluated by a doctor, and heavy bleeding, dizziness, or black stools need emergency care.
Can hemorrhoids turn into cancer?
No. Hemorrhoids do not turn into cancer or raise your risk of colorectal cancer. However, colorectal cancer can cause similar symptoms, such as bleeding, so new bleeding should be checked and a colonoscopy may be recommended. Learn about colon cancer evaluation and treatment.
What is the difference between internal and external hemorrhoids?
Internal hemorrhoids form inside the lower rectum and usually cause painless bleeding or prolapse. External hemorrhoids form under the skin around the anus and more often cause itching, pain, and lumps.
What is a thrombosed hemorrhoid?
A thrombosed hemorrhoid is an external hemorrhoid with a blood clot inside, causing a sudden, firm, painful lump. It often improves with home care over several days, but severe early pain may be relieved by removing the clot through a small incision.
Do hemorrhoids always need surgery?
No. Fewer than 1 in 10 patients need surgery. Most hemorrhoids improve with home care or an office procedure such as banding.
Does rubber band ligation hurt?
Banding is placed above the area that feels sharp pain, so most people feel pressure or a dull ache rather than pain, and it is done without anesthesia. Most people return to normal activities within a day or two.
What is the most effective hemorrhoid surgery?
Hemorrhoidectomy is the most complete treatment and has the lowest chance of hemorrhoids returning, but it also has the most recovery discomfort. Stapled hemorrhoidopexy and artery ligation procedures are usually less painful but more likely to need further treatment later.
How long is recovery after hemorrhoid surgery?
You may have discomfort for up to about three weeks after hemorrhoid surgery, and your surgeon may advise about two weeks off work. Light walking is encouraged during recovery.
Can hemorrhoids come back after treatment?
Yes. Hemorrhoids can return after any treatment, more often after office procedures than after hemorrhoidectomy. A high-fiber diet, plenty of fluids, and avoiding straining help prevent recurrence.
Sources and references
- Symptoms & Causes of Hemorrhoids, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Treatment of Hemorrhoids, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Definition & Facts of Hemorrhoids, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Hemorrhoids, American Society of Colon and Rectal Surgeons (ASCRS)
- Hemorrhoids, MedlinePlus, U.S. National Library of Medicine
Reviewed by the Review Team at Surgical Associates of Southern Texas.
Medical Disclaimer: This page provides general information and is not a substitute for medical advice. For heavy rectal bleeding, severe anal pain, fever, or other emergencies, call 911 or go to the nearest emergency room. Last updated October 16, 2026.
Schedule a Hemorrhoid Consultation
Have rectal bleeding, painful or prolapsing hemorrhoids, or hemorrhoids that keep coming back? Schedule a consultation with Dr. Murtaza Shakir to find the cause of your symptoms and learn whether home care, an office procedure or surgery fits you. Offices in Katy and Sugar Land serve Richmond, Fulshear and Greater Houston.
Contact us now