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THD stands for Transanal Hemorrhoidal Dearterialization. It's a relatively new technique for treating symptomatic hemorrhoids without surgical cutting. Nationally, very few surgeons offer this form of treatment. THD works by tying off the main blood vessels that feed the hemorrhoids. Without blood supply, the hemorrhoids shrink up, and the symptoms they caused (such as bleeding, sliding in and out, or pain) will resolve. Patients with hemorrhoids are especially interested in THD because there's 'no cutting', and because it's well known that traditional hemorrhoids surgery is quite painful. However, THD is not a 'painless' treatment for hemorrhoids. There's still discomfort, but probably from muscle spasm after the procedure, more than anything else. It's important for patients to understand that the type of treatment chosen for hemorrhoids varies from individual to individual. While some patients have an excellent response to dietary changes and a short course of suppositories, others may require office-based procedures such as rubber band ligation or IRC. More serious symptoms may require THD, while others benefit most from complete hemorrhoid excision. Below are photographs taken as Dr. Atallah performs THD. Learn more about THD.