Hemorrhoid Surgery Explained: What to Expect Before, During & After

Hemorrhoids are enlarged veins that can develop either inside the rectum (internal) or around the anus (external). Based on their type and severity, surgical removal may be an appropriate treatment option.

Hemorrhoids are categorized into four grades based on their severity:

• Grade 1: No prolapse
• Grade 2: Prolapse that resolves on its own
• Grade 3: Prolapse that requires manual pushing back
• Grade 4: Prolapse that cannot be pushed back in and causes significant discomfort

What is a hemorrhoidectomy?

A hemorrhoidectomy is a surgical method used to remove hemorrhoids. While surgery is not necessary for most individuals, it may be recommended if hemorrhoids are recurrent or lead to significant complications. In such cases, a hemorrhoidectomy can offer a permanent solution.

When Is Hemorrhoid Surgery Needed?

Surgical treatment is typically recommended when:

• Hemorrhoids are large and protruding
• There is excessive bleeding or persistent pain
• Conservative treatments such as creams, sitz baths, or dietary changes have failed
• Thrombosed hemorrhoids (with blood clots) are present
• There is a recurrence of symptoms despite treatment

What takes place prior to a hemorrhoidectomy?

Your surgeon will explain the advantages and risks of surgery and gain your consent. They'll also talk about your existing medication and which to discontinue prior to surgery.

They will instruct you to refrain from eating and drinking for eight hours prior to the surgery. Your anal canal must be free, so in case of constipation, they may administer an enema prior to the procedure.

What is hemorrhoidectomy surgery like?

You won't feel or realize anything is happening because you'll be under anesthesia during the procedure. Your doctor will find your hemorrhoids, remove (excise) the diseased tissue and close the vessels.

During the Procedure

Hemorrhoid surgery is usually done on an outpatient basis, meaning you can return home the same day. Here are the main types:

1. Hemorrhoidectomy:

This is the surgical removal of large external hemorrhoids or internal hemorrhoids that do not respond to other treatments. The surgeon excises the swollen tissue and seals the wound using sutures or cauterization. It is highly effective but may involve more postoperative discomfort.

2. Stapled Hemorrhoidopexy:

Also known as PPH (Procedure for Prolapse and Hemorrhoids), this involves stapling the hemorrhoidal tissue back into place inside the rectum and cutting off its blood supply. It generally causes less pain and allows for a quicker recovery than a hemorrhoidectomy, though it may not be suitable for all cases.

The procedure typically lasts between 30 to 60 minutes, depending on the complexity.

What happens following the hemorrhoidectomy procedure?

You can go home on the day of your surgery, but you'll need someone else to drive you home. It'll take a couple of hours for the anesthesia to completely wear off. When it does, you'll begin to feel pain.

You can take over-the-counter (OTC) pain medications, or you might have prescription pain medications to take home with you. You'll also receive instructions in detail on how to take care of yourself when you're recovering.

Diet and Bowel Habits:

Following a high-fiber diet is essential to avoid constipation and minimize pressure on the healing area. Incorporate fresh fruits, vegetables, whole grains, and increase your fluid intake.

In some cases, a stool softener may be prescribed to ensure smooth bowel movements.

Caring for the Surgical Site:

Maintaining cleanliness and dryness in the surgical area is important to prevent infection. Your doctor will give specific instructions regarding hygiene practices and dressing changes.

Avoid physically strenuous activities or lifting heavy objects during the initial weeks after surgery to prevent strain on the rectal area.

Follow-Up Visits:

You'll be scheduled for follow-up appointments to monitor healing progress and identify any signs of complications, such as bleeding, infection, or recurrence.

Conclusion

Hemorrhoid surgery is a safe and effective solution for individuals who have not found relief through conservative treatments. By understanding what the procedure entails—before, during, and after—you can take the necessary steps to support a smooth recovery. Always consult with a qualified surgeon to discuss the best treatment option for your condition and ensure personalized care.

If you're experiencing severe or persistent symptoms, don't hesitate to seek medical advice. Relief is possible, and a better quality of life awaits.