Hemorrhoidectomy surgery

What is a Hemorrhoidectomy surgery?

A hemorrhoidectomy is surgery to remove hemorrhoids, whether they’re internal or external.

Surgery is typically not the first line of treatment. But when all else fails, hemorrhoidectomy is a safe, effective treatment that doesn’t just make hemorrhoids easier to live with — it gets rid of them altogether.

Before Hemorrhoidectomy

Why is a hemorrhoidectomy performed?

If your hemorrhoids are severe, they can cause itching, bleeding, and pain. They can continue to swell, increasing in size over time.

Prolapsed internal hemorrhoids can cause some mild fecal incontinence, mucus discharge, and irritated skin. When the blood supply to internal hemorrhoids is cut off (strangulated), they can become gangrenous.

Hemorrhoids are fairly common, affecting nearly three out of four adults at some point in their lives. Most people are able to use noninvasive methods to manage symptoms. When those don’t work, hemorrhoidectomy can be an effective treatment.

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Who’s a good candidate for a hemorrhoidectomy?

Most people with hemorrhoids don’t require hemorrhoidectomy. Any type of surgery carries certain risks from the procedure itself, as well as from general anesthesia. For that reason, your doctor will likely recommend other, nonsurgical remedies first.

Surgical removal of hemorrhoids may be an option if:

. Less invasive methods haven’t worked for you

. Your hemorrhoids are severe and causing a lot of discomfort

. Internal hemorrhoids are strangulated

. External hemorrhoids are swollen due to a clot

. You have both internal and external hemorrhoids

. You need surgery for other anorectal conditions

Other considerations are your age, overall health, and how well you can be expected to react to surgery.

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What are the potential risks and side effects of a hemorrhoidectomy?

Hemorrhoidectomy is an invasive and sometimes painful treatment option, but it can be an effective, even permanent fix.

Complications are rare and not usually serious. These include:

. Slow healing

. Small tears that can cause pain that lasts several months

. Narrowing of the anus (stenosis) due to scar tissue

. Damage to sphincter muscles, which can lead to incontinence

. Urinary retention

Infection after hemorrhoidectomy isn’t common, but alert your doctor if you have:

. Fever, chills

. Nausea, vomiting

. Increasing pain

. Redness

. Swelling

. Severe discharge or bleeding

. Difficulty passing urine

. Constipation lasting more than 3 days, even after taking laxatives

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During Hemorrhoidectomy

What’s the procedure like?

Hemorrhoidectomy takes place in a hospital setting. It’s usually an outpatient procedure, but in some cases, it may require an overnight stay.

Pre-op instructions will advise you when to stop eating, which is usually 6 to 8 hours before surgery. You won’t be able to drive immediately, so be sure to arrange transportation home.

An IV will be inserted into your arm for medications to prevent infection, swelling, and bleeding. You’ll need either general anesthesia or local anesthesia with sedation to help you sleep through the procedure.

Once you’re asleep, the surgeon will insert a scope into the anal canal for closer examination of internal hemorrhoids. They’ll then cut the hemorrhoidal tissue with a scalpel or laser and close the wound with dissolvable sutures. This is called a closed hemorrhoidectomy.

In some cases, such as when there’s a high risk of infection or the area is very large, the incision isn’t sutured. This is called an open hemorrhoidectomy.

Another procedure, called hemorrhoidopexy, is somewhat less involved than hemorrhoidectomy. The surgeon uses staples to block blood flow, remove excess tissue, and lift hemorrhoids into a better position. This procedure comes with a greater risk of recurrence and rectal prolapse.

Once the surgeon is done, you’ll be moved to a recovery area where your vital signs will be monitored for several hours.

You’ll be able to drink and eat soon afterward. Within a few hours, you’ll be able to get out of bed. You’ll be discharged when you’re fully awake and stable.

After Hemorrhoidectomy

Hemorrhoidectomy Recovery

After you have hemorrhoids removed, you can expect to feel better each day. Your anal area will be painful or ache for 2 to 4 weeks. And you may need pain medicine. It is common to have some light bleeding and clear or yellow fluids from your anus. This is most likely when you have a bowel movement. These symptoms may last for 1 to 2 months after surgery.

After 1 to 2 weeks, you should be able to do most of your normal activities. But don’t do things that require a lot of effort. It is important to avoid heavy lifting and straining with bowel movements while you recover.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

. Activity

. Rest when you feel tired.

. Be active. Walking is a good choice.

. Allow your body to heal. Don’t move quickly or lift anything heavy until you are feeling better.

. You may take showers and baths as usual. Pat your anal area dry when you are done.

. You will probably need to take 1 to 2 weeks off work. It depends on the type of work you do and how you feel.

. Diet

. Follow your doctor’s instructions about eating after surgery.

. Start adding high-fibre foods to your diet 2 or 3 days after your surgery. This will make bowel movements easier. And it lowers the chance that you will get hemorrhoids again.

. If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fibre, a stool softener, or a mild laxative.

. Medications

. Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.

. If you take aspirin or some other blood thinner, ask your doctor if and when to start taking it again. Make sure that you understand exactly what your doctor wants you to do.

. Be safe with medicines. Read and follow all instructions on the label.

  . If the doctor gave you a prescription medicine for pain, take it as prescribed.

  . If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

. If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

. You may apply numbing medicines before and after bowel movements to relieve pain.

Other instructions

. Sit in 8 to 10 centimetres of warm water (sitz bath) for 15 to 20 minutes 3 times a day and after bowel movements. Then pat the area dry. Do this as long as you have pain in your anal area.

. Avoid sitting on the toilet for long periods of time or straining during bowel movements.

. Keep your anal area clean.

. Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position. This can make bowel movements easier after surgery.

. Use baby wipes or medicated pads, such as Tucks, instead of toilet paper after a bowel movement. These products do not irritate the anus.

. If your doctor recommends it, use an over-the-counter hydrocortisone cream on the skin in your anal area. This can reduce pain and itching after surgery.

. Apply ice several times a day for 10 minutes at a time.

. Try lying on your stomach with a pillow under your hips to decrease swelling.

When should you call for help?

Call your doctor or nurse or seek immediate medical care if:

. You have signs of infection, such as:

  . Increased pain, swelling, warmth, or redness.

  . Red streaks leading from the area.

  . Pus draining from the area.

  . A fever.

. You have pain that does not get better after you take your pain medicine.

. You are sick to your stomach or cannot keep fluids down.

. You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:

  . Pain in your calf, back of the knee, thigh, or groin.

  . Redness and swelling in your leg or groin.

. You cannot pass stools or gas.

Source:

. https://www.healthline.com/health/hemorrhoidectomy

. https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ud1119