Haemorrhoidectomy

What are haemorrhoids?

Haemorrhoids, also known as “piles,” are swollen blood vessels that form in your anus and rectum. They are sometimes described as the varicose veins of the anus and rectum and are very common. Nearly half of us will experience haemorrhoids at some point in our lives. Many us can manage symptoms by paying attention to our diet or using topical treatments when symptoms are minor.

For small internal haemorrhoids, banding can be an effective treatment. If your haemorrhoids are large, prolapse (drop down), or are associated with large external tags, surgical removal (haemorrhoidectomy) may be recommended.

What does a haemorrhoidectomy procedure involve?

You will usually be given an enema about an hour before the operation to clear the lower part of your bowel. The operation is performed under general anaesthetic. During the procedure, the haemorrhoids and tags are removed using an electrical cutting device (diathermy). Usually, the wounds are left open, but sutures are sometimes used to close larger wounds. The operation takes around 45 minutes to complete.

What are the potential risks and complications?

There are small risks associated with any operation. Before surgery, any heart, lung, or coexisting medical conditions will be assessed. During your hospital stay, you will wear stockings to prevent thrombosis (blood clots).

• Bleeding: You may notice small amounts of blood, particularly when opening your bowels. This is usually minor, but if you experience significant bleeding, you must seek medical advice.
• Infection: This is very rare, but if you develop increasing pain, fevers, or flu-like symptoms, you should seek medical advice immediately.

Longer-term complications are rare but may include:

• Stenosis: Narrowing of the back passage due to surgical scarring.
• Sphincter muscle damage: This can result in leakage problems after surgery.

What happens after haemorrhoidectomy?

Haemorrhoidectomy surgery can be painful afterwards. Your surgeon will inject a local anaesthetic into the area to numb the pain for a few hours.

If a dressing pack has been placed in your anus, it will be removed before you go home. You can eat and drink as soon as you feel able. You will normally go home on the same day as the operation.

You will be given painkillers to take regularly to prevent pain and, in some cases, antibiotics such as Metronidazole (Flagyl) to take for 7 days after the operation, as this has been shown to help with discomfort.

You may experience discomfort when you first open your bowels after the operation. It is very important that you do not avoid going to the toilet, as this discomfort will improve over time.

You will be given a regular stool softener to take for 4–6 weeks and will be advised to avoid straining.

You should aim to stay mobile after the procedure but avoid heavy lifting or strenuous physical activities for about 6 weeks.

You can usually resume driving after about 2 weeks, but this can vary depending on how you feel.

You will usually have a follow-up appointment about 6 weeks after your operation. However, you can be seen sooner if any problems arise.

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