Patient Information Leaflet
Haemorrhoidectomy
What are Haemorrhoids?
Haemorrhoids (piles) are swollen blood vessels in or around the back passage (anus). We all have haemorrhoidal cushions just inside our anus, these are part of our normal continence function. However, they can become larger than necessary and this is when they start to cause symptoms.
They can cause symptoms such as bleeding, pain, itching, swelling, and lumps. The haemorrhoids can prolapse at the anal verge following the passage of stool and may reduce on their own or require encouragement to do so.
They are very common and often related to constipation, straining or pregnancy. If haemorrhoids have been present for a period of time they can leave an external component at the anal verge that will not reduce. These are called external haemorrhoids or anal skin tags.
Why Might I Need Surgery?
Most haemorrhoids can be treated with lifestyle changes, creams, or minor procedures. If these treatments fail or if haemorrhoids are very large, painful, or frequently bleeding, surgery (haemorrhoidectomy) may be advised.
There is no necessity to operate on haemorrhoids, and it is for each individual patient to way up their personal situation. Have they reached a point that one is prepared to go through surgery in an effort to improve their symptoms.
The Operation
Haemorrhoids are removed through an operation, under a general anaesthetic (you are asleep). The haemorrhoidal tissue and any external skin component is cut away leaving raw wounds at the anal verge that will extend up inside the anal canal. Surgery will take between 30-60 minutes to perform.
Local anaesthetic will be placed around the anal verge to help with the initial post-operative pain relief.
The raw wounds at the anal verge are very painful, you will be given pain killers and laxatives to help with this. Usually the first two weeks are very sore and then the wounds start to improve over the next 4-6 weeks. It usually takes between 2-3 months for the wounds to fully heal.
Risks and Possible Complications
All operations carry some risks. Complications after haemorrhoidectomy may include:
Pain, especially during bowel movements.
Bleeding from the operation site.
Difficulty passing urine (temporary).
Infection around the wound.
Rarely a non-healing wound.
Anal narrowing or scar tissue (rare), called anal stenosis at a risk of <1%.
Recurrence of haemorrhoids over time.
Reaction to anaesthesia.
After the Operation
Most patients go home the same day or after an overnight stay if it is late in the day. Pain is common, especially when opening your bowels; painkillers and stool softeners will be given.
A high-fibre diet and plenty of fluids will help keep stools soft. Try and avoid straining when passing stools. Keep the area clean – regular baths or showers are recommended. You may find the use of a Sitz bath helpful in keeping the wound clean.
You may need 2–3 weeks off work, depending on your job. We can provide you with a sick note if required.
If you experience any issues or concerns during the post-operative period, please contact the hospital you had your surgery at on the contact number provided to you on your discharge. Alternatively, my secretary can be contacted by email (secretary@sussexsurgeon.com) or phone 07963 466976. Her working hours are between 09:00 to 16:30 Monday to Friday, except Wednesday.
Follow-Up
I will see you for follow up in clinic between 6 to 8 weeks following surgery.
Andrew Day