Hemorrhoid surgery. Hemorrhoidectomy. When All Else Fails

Hemorrhoids are swollen veins around the anus, we all have them, but in some cases, when not properly taken care of, they can become a serious problem. If you experience the symptoms and do not properly take care of them, they can start to bleed heavily and cause a lot of pain. In this case, medical attention and surgery may be the only way.

This can be avoided

There are several natural aids available to avoid hemorrhoid surgery and treat them from home. The key is holistic approach combined with natural treatment.  This will help you to change your thinking and heal your hemorrhoids for life.  Read the complete guide to holistic hemorrhoid treatment.

First and most important is to change your lifestyle. Eat more fiber-rich foods and drink enough water. Move and avoid sitting for long periods. Go out and exercise - walking or running every day for at least 30 minutes is very important. Keep your body fit as being overweight is one of the risk factors for hemorrhoids.

Also strengthening the core muscles and the anal area may be the savior. We have listed Kegel exercises here, to help you to do so.

If you fail to take proper action or all attempts to apply natural treatment fail medical attention may be inevitable. In that case, you will need to use hemorrhoid surgery, also known as hemorrhoidectomy.

Although, if not followed up with lifestyle changes hemorrhoids may still come back. Therefore it is important to understand the root causes and apply proper lifestyle changes and hemorrhoid treatment.

About hemorrhoid surgery

Hemorrhoid surgery can be done in your healthcare provider's office or in the hospital operating room. In most cases, you can go home the same day. The type of surgery you have depends on your symptoms and the location and size of your hemorrhoids.

Before the surgery, your doctor will numb the area so you can stay awake, but not feel anything. For some types of surgery, you may be given general anesthesia. This means you will be given medicine in your vein that puts you to sleep and keeps you pain-free during surgery.

Hemorrhoid surgery may involve

• Putting a small rubber band around the hemorrhoids to shrink it by blocking blood flow.
• Stapling the hemorrhoids to block blood flow, causing it to shrink.
• Using a knife (scalpel) to remove hemorrhoids. You may or may not have stitches.
• Injecting a chemical into the blood vessel of the hemorrhoids to shrink it.
• Using a laser to burn the hemorrhoids.

How to avoid hemorrhoids surgery

Main cases you can manage small hemorrhoids by:

• Eating a high fiber diet
• Drinking more water
• Avoiding constipation (taking a fiber supplement if needed)
• Training
• Not straining when you have a bowel movement

When these actions do not work and you still are having bleeding and pain in anus area, your healthcare provider may recommend hemorrhoid surgery.

When hemorrhoid surgery is done

When you have:

• Internal hemorrhoids still cause symptoms after nonsurgical treatment.
• Very large internal hemorrhoids.
• Large external hemorrhoids that cause significant discomfort and make it difficult to keep the anal area clean.
• Both internal and external hemorrhoids.
• Other treatments for hemorrhoids such as rubber band ligation that have failed.

Risks

• Bleeding
• Infection
• Leaking a small amount of stool (long-term problems are rare)
• Problems passing urine because of the pain

Before the procedure

Hemorrhoid surgery is a serious act with your body, so several days before surgery, you may be asked to stop taking medicines that make it hard for your blood to clot. These medicines include:

• Aspirin
• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve, Naprosyn)
• Warfarin (Coumadin)
• Clopidogrel (Plavix) etc.

Be sure to tell your provider

• What medicines you are taking, including over-the-counter medicines, supplements, or herbal remedies.
• About any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.

On the day of your surgery

• Follow your provider's instructions about when to stop eating and drinking.
• Take any medicines you are asked to take with a small sip of water.
• You will be told when to arrive at the hospital. Be sure to arrive on time.

What to expect at home after the hemorrhoid surgery

Usually, you may go home the same day after the surgery. Be sure you arrange to have someone drive you home. You may have a lot of pain after surgery as the area tightens and relaxes.

• If you have a pain after surgery, take the pain medicines on time as instructed. Don’t wait until the pain gets bad to take them. Ask your doctor what medicines are safe for you.
• Some bleeding is normal, especially after your first bowel movement.
• Ice packs applied to the anal area may reduce swelling and pain.
• Your doctor may also recommend eating a bland diet the first few days after surgery. A bland diet includes foods that are soft, not very spicy, and low in fiber. You should not drink alcohol or drinks with caffeine in them.
• Frequent soaks in warm water (sitz baths) help relieve pain and muscle spasms.
• Your healthcare provider will tell you when you can start eating other foods again. It is important to eat healthy foods. A dietitian or nutritionist can help you to plan a healthy diet.
• Be sure to drink plenty of fluids, such as water, light tea, broth and juices.
• Your healthcare provider may suggest using a stool softener so that it is easier to have bowel movements.
• Some doctors may recommend that you take an antibiotic (such as metronidazole) after surgery to prevent infection and reduce pain.
• Follow-up exams with the surgeon usually are done 2 to 3 weeks after surgery to check for problems.

Bland diet

Diet includes:
low-fat or fat-free milk and other dairy products; cooked, canned, or frozen vegetables; fruit juices and vegetable juices, but avoid citrus; bread, crackers, and pasta; poultry, whitefish, and shellfish that are steamed, baked, or grilled with no added fat; peanut butter; pudding and custard; eggs; tofu; soup broth; bland tea.

Foods to avoid:
fatty dairy foods, such as whipped cream or high-fat ice cream; strong cheeses; raw vegetables; vegetables that make you gassy, such as broccoli, cabbage, cauliflower, cucumber, green peppers, and corn; seedy fruits such as berries or figs; dried fruits; whole-grain or bran cereals; whole-grain breads, crackers, or pasta; pickles, sauerkraut, and similar foods; spices, such as hot pepper and garlic; foods with a lot of sugar in them; seeds and nuts; highly seasoned, cured or smoked meats and fish; fried foods; alcoholic beverages and drinks with caffeine in them.

Eating tips:
eat small meals, and eat more often during the day; chew your food slowly, and chew it well; stop smoking cigarettes, if you smoke; don’t eat within 2 hours of your bedtime; don’t eat foods that are on the "foods to avoid" list, especially if you do not feel well after eating them; drink fluids slowly.

Recovering from surgery

Most people do very well after hemorrhoid surgery. You should recover fully in a few weeks, depending on how involved the surgery was. You will need to continue with diet and lifestyle changes to help prevent the hemorrhoids from coming back.

How Well It Works

Surgery usually removes the hemorrhoids problem. But the long-term success for staying hemorrhoids free will need a complete approach which may include several lifetime changes. Therefore read this four step holistic treatment process to relieve and treat your hemorrhoids for life.

References

Chaudhry V, Abcarian H. Hemorrhoids. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 11th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 53.
Hall JF. Hemorrhoids and hemorrhoidectomy. In: Delaney CP, ed. Netter's Surgical Anatomy and Approaches. Philadelphia, PA: Elsevier Saunders; 2014:chap 26.

Review Date 4/5/2015 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

Thompson M, Noel MB. Nutrition and family medicine. In: Rakel RE, Rakel D, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 37.