Hemorrhoids are a very common condition. They are located outside the anus or inside the anus and rectum. They may enlarge and swell, leading to pain, discomfort, and sometimes rectal bleeding. If you are in too much pain due to hemorrhoids, experience rectal bleeding, or have recurring hemorrhoids even after non-surgical interventions, your gastroenterologist will recommend surgery.
Before a hemorrhoid surgery or hemorrhoidectomy, the doctor will examine and grade your hemorrhoid depending upon its size and position to provide the best solution. Generally, there are four grades of hemorrhoids-
- Grade I: Hemorrhoids do not protrude, but may bleed.
- Grade II: Hemorrhoids protrude during bowel movements and reduce spontaneously afterwards.
- Grade III: Hemorrhoids protrude and do not reduce spontaneously. They can be manually pushed back.
- Grade IV: Hemorrhoids are permanently prolapsed and are visible outside the anus.
Usually, grade I and grade II hemorrhoids are treated using non-surgical methods. However, the best treatment plan for very symptomatic grade III and grade IV hemorrhoids especially when skin tags are present, is a surgical hemorrhoidectomy.
If you have very painful and problematic hemorrhoids that are constantly interfering with your routines and reducing the quality of your life, your gastroenterologist will recommend a hemorrhoidectomy surgery. However, there are a few things you must understand about the procedure and subsequent recovery phase. So in this blog, we will learn more about hemorrhoids surgery and things you must remember about recovering from the procedure.
Hemorrhoidectomy Surgery: The basics
While there are different techniques to remove hemorrhoids, the general method is discussed here. Hemorrhoidectomy is done under general or spinal anesthesia to ensure that the patient doesn’t feel any pain. During the procedure, the hemorrhoid doctor will remove the hemorrhoids using scalpel or energy devices . The excess hemorrhoid tissue is removed, following which the surgical area may be sewn shut or left open. The region is then covered in medicated gauze. The procedure is done on an outpatient basis and allows you to return home on the same day of the surgery.
Sometimes, doctors may use a different technique where the hemorrhoid is lifted and stapled back into the anal canal. This surgical procedure is termed stapled hemorrhoidopexy. Although this procedure causes less discomfort during the healing periods, people who have stapled surgery are more likely to have recurring incidences of hemorrhoids.
It is to be noted that gastroenterologists don’t recommend hemorrhoids surgery to all patients. You may have to undergo hemorrhoidectomy only if you have very large internal hemorrhoids, hemorrhoids that cause symptoms after nonsurgical interventions, large external hemorrhoids that cause a lot of discomforts, multiple hemorrhoids, and when all other treatments have failed.
Recovering from a hemorrhoid surgery
Typically, patients recover from a hemorrhoids surgery in around six weeks, depending upon the type of treatment and severity of the hemorrhoids removed. While it is natural to experience some pain and discomfort for one to four weeks, some patients may experience a very painful recovery. Your doctor will recommend you follow certain steps to ease your recovery.
Most patients will begin to feel better at the end of their first week itself. As pain becomes significant during bowel movements, your doctor will prescribe a stool softener to keep it soft or slightly loose.
Along with taking the recommended dose of stool softener, make sure that you consume a lot of fluids and fiber to avoid constipation. If stool becomes hard, causing you to strain, it will increase your pain and may delay your recovery. Sometimes, pain medications prescribed for the recovery period may cause constipation. Therefore, if you already suffer from constipation and are on medication, talk to your doctor to adjust the dosage of your medicines to help you through the recovery period.
If you don’t experience any issues as such during your recovery period, you will be able to return to non-strenuous activities a week after the surgery. You should be able to resume your daily routines, including exercising within a couple of weeks as long as you are on a steady recovery path.
With that said, some people may have a tougher recovery journey. Pain is a common experience in the week following the hemorrhoid surgery. Patients who had a regular hemorrhoidectomy will have more pain than others who had less invasive procedures. The level of pain you experience also depends on the severity of the removed hemorrhoids and the stool consistency during bowel movements. Remember that hemorrhoidectomy performed to remove large or multiple hemorrhoids will have bigger incisions and therefore cause significant pain during the first week of recovery. To cope with the pain, take your prescribed pain medication or over-the-counter medication such as ibuprofen for the recommended duration. Additionally, remember to take a stool softener or laxative as recommended by your doctor during your recovery.
Along with the medication, you must also consume a lot of fluids and maintain a high fiber diet throughout the recovery phase. Make it a point to drink no less than 8 cups of water every day to keep your digestion smooth and ease your bowel movements.
Many patients also experience itching, bleeding, and or fecal incontinence during the recovery period. These symptoms are common immediately after the procedure. Some topical hemorrhoid creams can effectively relieve itching; however, consult with your doctor to see which one is appropriate to use during your recovery. If fecal incontinence doesn’t improve over time or if bleeding is quite significant, don’t hesitate to talk to your gastroenterologist. Your doctor will be able to treat you for the symptoms and put you back on your recovery path.
Like with any surgery, there is a risk of infection after the hemorrhoid surgery as well, especially due to its location. To avoid this, ensure that you wash and clean the site every time after a bowel movement to remove any traces of stool. If you experience fever or more specific signs such as pus and increased bleeding from the surgery site, report back to your doctor to receive immediate care.
For better pain management and faster healing, a sitz bath may also be recommended by your doctor. The sitz bath is a special basin that will fit over a toilet. Fill this basin with a few inches of warm water and sit on it to soak the rectal area several times a day, especially after a bowel movement.
As your pain subsides, you may resume your normal activities. Routines involving bending, stretching, lifting, squatting, etc will cause some minor discomfort for a few weeks following the surgery. Listen to your body and let the pain be your guide as you return to your everyday life.
Surgery and beyond
While a straightforward hemorrhoidectomy gives a more permanent solution for hemorrhoids, stapling and other procedures are found to have a higher rate of recurrence. To prevent this and avoid further treatments, ensure that you follow a healthy lifestyle involving exercises, a fiber-rich diet, and better hydration. recommendations can significantly reduce the likelihood of forming additional hemorrhoids.
If you are suffering from hemorrhoids and need a more permanent solution, book a consultation with Dr. Antonio Privitera, renowned speaker and practicing proctologist in Dubai. With the right medical intervention, you can now have a quality life free of hemorrhoids and the discomfort that comes with them.