Hemorrhoidectomy Overview

A hemorrhoidectomy is an operation to remove hemorrhoids. Hemorrhoids are swollen (dilated) veins located in or around the anus and rectum. Hemorrhoids can cause discomfort, pain, or bleeding.

Hemorrhoid © 2009 Nucleus Medical Media, Inc.

Prior to Procedure

Your doctor may do the following:

• Physical exam
• Rectal exam
• Anoscopy—the visual examination of the inside of the anus using a short tube (anoscope) to help keep the sphincter open
• Sigmoidoscopy —the use of a specialized endoscope (a tube attached to a viewing device) to examine the inside of the anus, rectum, and lower intestine

Leading up to the procedure:

• Do not eat or drink anything after midnight.
• Your doctor will order a laxative for you. It will cleanse your colon and rectum.
• Arrange for someone to take you home after the surgery.
• Talk to your doctor about your medicines, even non-prescription medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, like warfarin (Coumadin) or heparin
• Clopidogrel (Plavix)

Anesthesia

Your surgery will be done using either:

• Spinal anesthesia —You will be numb from the mid-abdomen down.
• General anesthesia —You will be asleep.

Discuss these options with your doctor before the day of your surgery.

Description of the Procedure

An anoscope will be inserted into your anus. The doctor will be able to see the hemorrhoids through the scope.

An incision will be made around each hemorrhoid. The swollen vein inside the hemorrhoid will be tied off so that it does not bleed. The hemorrhoid will then be removed. The wounds will either be stitched closed or left open to heal.

There are other variations of this procedure. Ask your doctor to describe which procedure will be used.

Immediately After Procedure

You will be monitored in a recovery area for a few hours.

How Long Will It Take?

About 1-2 hours

How Much Will It Hurt?

You should not feel pain during the procedure. After the procedure, you might have pain in the area. Your doctor will give you pain medicine if you need it.

Post-procedure Care

Be sure to follow your doctor's instructions , which may include:

• Take sitz baths as recommended. Sitz baths will help relieve discomfort and clean the area. For a sitz bath, sit in warm water for 10-15 minutes. Pat the area dry. Do not wipe or rub vigorously. You may be advised to take a sitz bath every four hours and after every bowel movement. Devices are available to place on top of the toilet to make this process easier.
• Move your bowels as soon as you feel the urge.
• Do not strain, bear down, or hold your breath during a bowel movement.
• Do not sit on the toilet for long periods of time.
• To prevent constipation and straining during bowel movements, use a stool softener, exercise, drink plenty of fluids, and eat plenty of high-fiber foods ( fruits, vegetables , beans, and whole grain ).
• Apply creams or ointments as directed by your doctor.
• Avoid heavy lifting for two or three weeks.
• Use stool softeners.
• Take pain medicine as needed.

Complete recovery will take 2-3 weeks. If your hemorrhoids come back, let your doctor know.

RESOURCES:

American Gastroenterological Association
http://www.gastro.org/

American Society of Colon and Rectal Surgeons (ASCRS)
http://www.fascrs.org/

Familydoctor.org
American Academy of Family Physicians
http://familydoctor.org/online/famdocen/home.html/

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov/

CANADIAN RESOURCES:

The Canadian Association of Gastroenterology (CAG)
http://www.cag-acg.org/

The College of Family Physicians of Canada
http://www.cfpc.ca/

References:

Khatri VP, Asensio JA. Operative Surgery Manual. Philadelphia, PA: WB Saunders; 2003.

Townsend CM. Sabiston Textbook of Surgery. 17th ed. St. Louis, MO: WB Saunders; 2004.

Yamada T. Textbook of Gastroenterology. 4th ed. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2003.