Can I avoid surgery for hemorrhoids?
Typical story of  a patient who could have avoided surgery.

Stage 1: A young patient has a first episode of fresh, painless bleeding. At this stage an examination will reveal grade 1 internal piles. These can be generally  controlled by infrared coagulator. However patient takes some medications like laxatives etc. and bleeding stops.

Stage 2: Subsequently, patient bleeds again. Now he has got used to self medication and may not even report to his physician.
              He may well obtain the same medicines from the drug stores and get temporary relief.

Bleeding can be stopped; but piles will not be stopped!

Stage 3:  At some point of time the low grade internal piles attain a size such that it  prolapses out of anal canal at time of defecation. Patient if seen by a doctor is generally advised surgery at this stage.  

Q: Doc, can you not cure me without operation?
A: The stage where such modalities as infrared coagulator could have benefited you is long gone by. Neglecting the episodes of bleeding results in natural advancement of the grade of piles which then require a surgical intervention. 
Timely use of appropriate methods like IRC may halt or delay the advancement of internal piles to a stage where surgery is unavoidable.