Recovering from Hemorrhoid Surgery: What to Expect

Table of Contents

• What are Hemorrhoids?
• Preparing for Hemorrhoid Surgery
• The Hemorrhoidectomy Procedure
• Recovering from Hemorrhoid Surgery
• When to Call Your Doctor After Surgery
• Conclusion

What are Hemorrhoids? Including Keywords

Hemorrhoids, also known as piles, occur when the veins in the walls of the rectum and anal canal become swollen and the surrounding tissue becomes inflamed. Hemorrhoids can be extremely painful and disrupt daily life, but surgery can effectively remove them.

There are two main types of hemorrhoids: external and internal. An external hemorrhoid refers to a swollen vein near the opening of the anus. An internal hemorrhoid refers to a swollen vein inside the rectum.

External vs Internal Hemorrhoids

External hemorrhoids occur under the skin surrounding the anus. They often cause pain, itching, and bleeding during bowel movements. External hemorrhoids can usually be seen or felt as soft lumps around the anal opening. Internal hemorrhoids develop inside the lower rectum, are typically painless, and usually go unnoticed. As they grow larger, they can protrude outside the anus and become irritated and painful. There are four stages of internal hemorrhoids based on severity:

• First-degree: Remain inside the rectum at all times
• Second-degree: Prolapse outside the anus during bowel movements but retract back inside on their own
• Third-degree: Prolapse but must be manually pushed back inside
• Fourth-degree: Remain permanently prolapsed and cannot be pushed back inside

Stages of Internal Hemorrhoids

Internal hemorrhoids typically develop gradually over time. As pressure increases in the lower rectum from factors like constipation or pregnancy, the veins get pulled downward and begin bulging into the anal canal. Most internal hemorrhoids start out at a first or second degree. At these stages they usually don't cause discomfort. It's only when they reach the third or fourth degree that they become painfully prolapsed outside the anus.

Preparing for Hemorrhoid Surgery

If hemorrhoids do not respond to more conservative treatments like over-the-counter ointments, dietary changes, or rubber band ligation, a surgical hemorrhoidectomy may be recommended to remove them.

Before hemorrhoid removal surgery, patients meet with the surgeon to discuss the procedure and ask any questions. Preoperative preparation may involve fasting after midnight if general anesthesia will be used.

The doctor reviews the patient's medical history and medications and performs a physical exam to rule out any issues that could complicate surgery. Bloodwork or medical clearances from other providers may also be needed beforehand.

The Hemorrhoidectomy Procedure

During a hemorrhoidectomy, the surgeon makes an incision around the hemorrhoid to cut out the entire swollen vein cluster and inflamed tissue. This is usually done using a scalpel, electrocautery device, or laser.

If the hemorrhoid is bleeding heavily, the surgeon may tie it off to control blood loss before excising it. After removal, the surgeon inspects the wound carefully and decides whether to leave it open or stitch it closed.

At the end of surgery, medicated bandages are placed over the incision site to aid healing and prevent infection. The procedure usually takes about an hour with patients under local or general anesthesia.

For general anesthesia, medications are administered intravenously or through a breathing mask to put patients fully asleep. A breathing tube is inserted to maintain proper respiration throughout surgery.

Recovering from Hemorrhoid Surgery

The first bowel movement after hemorrhoid surgery is often painful, so doctors recommend taking warm baths and stool softeners during the recovery period to keep stool loose. Sitting on a rubber or pillow donut may provide some relief as well.

Most patients can go home the same day but may need 1-2 days of hospitalization after surgery if the hemorrhoids were significantly complex. Recovery typically takes 2-4 weeks for incision sites to close up.

It is crucial to avoid straining, lifting heavy objects, and vigorous exercise during the healing phase to prevent wound breakdown or bleeding flare-ups. A high fiber diet and lots of fluids are beneficial to prevent painful constipation.

When to Call Your Doctor After Surgery

Patients should contact their surgeon right away if they experience concerning symptoms in the weeks following hemorrhoid removal such as:

• Fever over 101°F

• Excessive rectal pain or enlarging pain over time

• Persistent bleeding from the anus

• Pus or foul odor coming from the surgical wound

• Significant swelling, redness, or warmth around the anus

Conclusion

A hemorrhoidectomy is an effective way to remove painful, prolapsing hemorrhoids that do not respond to other treatments. While recovery can involve significant discomfort, most patients find great relief from their symptoms after the procedure.

Closely following your surgeon's postoperative directions can help prevent complications so you can get back to comfortable, normal bowel movements as quickly as possible.

FAQ

Q: What are the signs that hemorrhoid surgery is needed?
A: If conservative treatments like diet changes, medications, and warm baths don't reduce hemorrhoid swelling and discomfort, your doctor may recommend surgery.

Q: What kind of anesthesia will be used?
A: You may be given local or general anesthesia before a hemorrhoidectomy. General anesthesia will make you sleep through the procedure.

Q: How is the surgery performed?
A: The surgeon cuts out the swollen hemorrhoid tissue and ties off blood vessels. The wound may be left open or stitched closed before bandages are applied.

Q: How long does recovery take?
A: The recovery period usually lasts 2 weeks to 2 months. Your doctor will recommend diet changes, medications, warm baths and stool softeners to aid healing.

Q: When can I return to normal activities?
A: Most people can go home the day of surgery, but some may need to stay 1-2 days. You should avoid strenuous activity during recovery, but can resume normal routine gradually as healing allows.

Q: What complications should I watch for?
A: Call your doctor if you have fever, excessive pain, wound drainage, or redness/swelling which could indicate infection or other issues.

Q: Will I need additional procedures?
A: If the hemorrhoids don't respond to surgery, your doctor may recommend further interventions like more surgery, banding procedures, or prescription medications.

Q: How can I prevent hemorrhoids from returning?
A: Eating more fiber, drinking fluids, exercising, and treating constipation can help prevent recurrence of hemorrhoids after surgery.

Q: Is surgery an outpatient or inpatient procedure?
A: Hemorrhoid surgery is usually an outpatient procedure allowing you to go home the same day in most cases. Some people may need a 1-2 day hospital stay.

Q: How successful is hemorrhoid surgery?
A: When performed appropriately, hemorrhoidectomy has over a 90% success rate for significant, long-term improvement or complete removal of hemorrhoid symptoms.