Is surgery the only way of treatment of hemorrhoid for permanent relief?

No: There are dietary changes as well as other nonsurgical modalities that can be tried.

Get diagnosed first: The short answer is no. The proper answer is see a doctor who can do an exam and correctly diagnose the problem first- such as a colorectal surgeon. Most patients with hemorrhoids get enough relief with nonoperative management, so surgery is reserved for those who don't respond. I always start with making sure folks have enough fiber and water in their daily diet.

Even after surgery: They can come back, especially if you are obese, constipated, or smoke.