Hemorrhoids refer to the swollen veins in the lowest part of your rectum and anus. These are commonly known as piles. It is one of the causes of rectal bleeding. It is usually not a life-threatening condition, and can be treated in a couple of weeks.
Hemorrhoids can either be internal or external.
- External hemorrhoids: This is the most common type of hemorrhoids. These hemorrhoids develop outside the anus.
- Internal hemorrhoids: This type of hemorrhoids develops on the inner lining of the rectum. They may prolapse, and cause pain and itching. Based on the degree of prolapse the internal hemorrhoids are classified into four grades.
- Grade I hemorrhoids have not prolapsed.
- Grade II hemorrhoids prolapse upon bearing down but reduce spontaneously when the pressure is relieved.
- Grade III hemorrhoids prolapse upon bearing down and require manual reduction.
- Grade IV hemorrhoids are prolapsed and cannot be reduced manually.
Many treatments are effective for hemorrhoids; hemorrhoidectomy is one among them.
What is hemorrhoidectomy?
It is a surgical procedure to remove the internal or external hemorrhoids that are extensive and severe. It is the most effective treatment for hemorrhoids.
Types of hemorrhoidectomy
The types of hemorrhoidectomy procedures include:
- Excisional hemorrhoidectomy: In this procedure, your surgeon removes the hemorrhoidal tissue and leaves the tissue wound either opened or sutured.
- Stapled hemorrhoidectomy: In this procedure, a portion of hemorrhoidal tissue is removed, and the remaining tissue is stapled with a special staple device.
What is the purpose of the surgery?
The main purpose of the surgery is to relieve the symptoms associated with hemorrhoids. The surgery is appropriate if the:
- Internal hemorrhoids are very large
- Internal hemorrhoids still cause symptoms after the nonsurgical treatment
- Large external hemorrhoids cause significant discomfort
- Other treatments for hemorrhoids have failed (rubber band ligation)
What are the risks of the surgery?
The risks of the surgery include:
- Bleeding from the anal area
- Inability to urinate
- Infection of the surgical area
- Fecal impaction
- Narrowing of the anal canal
- Recurrence of the hemorrhoids
- Rectal prolapse
Before the surgery:
- You need to stop taking drugs such as aspirin, Advil, etc.
- You should quit smoking.
- You should avoid drinking or eating anything for 6 to 12 hours
During the surgery:
Your anesthetist will administer general anesthesia or spine anesthesia. A small volume of saline enema is used to clean the rectal area and the lower part of the large intestine. Your surgeon makes the incision in the tissue around hemorrhoid. Then the hemorrhoids are clamped, tied and removed. Finally, the surgical area may be sutured or left open. Medicated gauze is used to cover the wound.
After the surgery:
The recovery takes about 2 to 3 weeks. Your surgeon may suggest you to follow certain instructions which include:
- Take pain medications and antibiotics to manage pain
- Drink liquids and eat a bland diet (low fiber and soft foods) for few days
- Apply numbing medicines before or after the bowel movements to relieve pain
- Apply ice packs to the anal area to reduce swelling and pain
- Take sitz bath (sitting in shallow bath water for 25 to 20 minutes)
- Avoid lifting heavy weights for at least 5 to 7 days.
Do not panic about the risks associated with the surgery. Know the facts of the surgery which helps to restore your normal activities. Seek your doctor if you have any misconceptions about the surgery