What hemorrhoids actually are.
Hemorrhoids are swollen blood vessels in the lower rectum and anus. Everyone has hemorrhoidal tissue — it's a normal part of anatomy that helps with continence. The clinical problem starts when those vessels become enlarged, irritated, or thrombosed (clotted).
There are three working categories. Internal hemorrhoids sit above the dentate line and are usually painless; they tend to announce themselves through bright red bleeding during bowel movements. External hemorrhoids sit below the dentate line under sensitive skin and can be intensely painful, especially if a clot forms inside one (a thrombosed external hemorrhoid). Some patients have both.
How Dr. Maz approaches treatment.
The first principle: most hemorrhoids never need surgery. The second: when they do, the surgery should be performed by someone who does it routinely and treats post-operative comfort as a design goal, not an afterthought.
Conservative & in-office (the vast majority of cases)
- Sclerotherapy. An injection that shrinks small internal hemorrhoids.
- Infrared coagulation. A heat-based laser treatment for grade I and II internal hemorrhoids.
- Topical and behavioral protocols. Targeted prescriptions, fiber strategy, and habit changes that often resolve mild cases entirely.
- Rubber band ligation. A small band cuts off blood supply to the swollen tissue, which falls off painlessly within a few days.
Thrombosed external hemorrhoids
When a painful external clot is recent, in-office excision under local anesthesia provides immediate relief — usually within minutes of walking through the door.
Surgical hemorrhoidectomy
For cases that haven't responded to conservative treatment, or for prolapsing grade III–IV internal hemorrhoids, surgery is the durable solution. Dr. Maz performs hemorrhoidectomy with techniques designed to minimize post-operative pain.
What the visit actually looks like.
A typical first visit takes about 30 minutes. After a brief, focused conversation about what brought you in, the exam itself takes only a few minutes — patients often times report it's far less uncomfortable than they expected. Many leave with their treatment already started.
"They took high-definition images so when the treatment was over, they showed me exactly what was going on. No other doctor had done that." — Patient, internal hemorrhoid care
For patients who would rather start remotely, a $149.95 telehealth visit can establish a treatment plan before you ever come into the office — or the $49.95 photo consult offers a discreet labeled educational starting point.
Common questions.
Will I need surgery?
The large majority of hemorrhoid cases — even severe-feeling ones — resolve with in-office treatment. Surgery is reserved for cases that don't respond, or for advanced prolapsing internal hemorrhoids.
Is the in-office treatment painful?
Banding, sclerotherapy, and infrared coagulation laser hemorrhoid treatment are essentially painless. Patients are routinely surprised at how unremarkable the procedure feels. In-office excision of a thrombosed external hemorrhoid involves a small local anesthetic injection, after which the procedure itself is quick and dramatically reduces pre-existing pain.
How long does recovery take?
For in-office procedures, most patients return to normal activity the same day. For surgical hemorrhoidectomy, recovery typically can vary, with the most uncomfortable period in the first 4–7 days.
Will they come back?
Recurrence is possible, especially without addressing underlying contributors (diet, fiber, straining habits). A good treatment plan includes ongoing prevention — not just symptom relief.