Surgical treatment for hemorrhoids is primarily indicated for which grades?

Surgical treatment for hemorrhoids is primarily indicated for grades III and IV due to the severity and complications associated with these grades.

Grade III hemorrhoids are characterized by prolapse that occurs with straining but requires manual reduction. Patients often experience significant symptoms, including persistent bleeding, pain, and discomfort. When conservative treatments are insufficient to manage these symptoms effectively, surgical intervention becomes necessary to alleviate the patient's condition.

Grade IV hemorrhoids represent an even more severe situation where the hemorrhoids are permanently prolapsed and cannot be reduced manually. This condition can lead to severe pain, bleeding, and potential complications such as thrombosis or necrosis. Surgical intervention is crucial in this case to prevent further complications and provide significant relief for the patient.

In contrast, grade I hemorrhoids typically do not present with prolapse; they generally respond well to conservative management such as dietary modifications and topical treatments. Grade II hemorrhoids, while they may prolapse during straining, typically reduce spontaneously and often resolve with non-surgical measures. Thus, while these grades may be symptomatic, they are not the primary candidates for surgical treatment like grades III and IV.