Haemorrhoid surgery

Haemorrhoids (piles) are varicose veins that occur inside, on or just outside the anus. The cause is not definitely known but family history, pregnancy or having an occupation that involves a lot of standing are possible risk factors.

Increased pressure inside the abdomen, caused by constipation and the straining to pass a bowel motion, may also cause haemorrhoids. Large haemorrhoids that are visible outside the anus and are painful and itchy are often treated surgically with a procedure called a haemorrhoidectomy.

Problems associated with haemorrhoids
Some of the problems associated with haemorrhoids include:

• Pain
• Bleeding from the anus
• Strangulated haemorrhoids, when the anal sphincter (ring of muscle) squeezes the prolapsed haemorrhoids and interrupts blood flow.

• Medical history
• Bad reactions or side effects from any drugs, which may influence the choice of anaesthesia
• Your diet – avoiding constipation helps to both prevent and treat haemorrhoids.

• Sclerotherapy – a chemical is injected into the blood vessels that ‘service’ the haemorrhoids. This prompts the vessels to spasm and seal shut. Starved of oxygen and nutrients, the haemorrhoids shrivel.
• Ligation – a tight rubber band is wrapped around the haemorrhoids to cut off their blood supply. Starved of oxygen and nutrients, the haemorrhoids shrivel.
• Laser surgery – precisely targeted laser beams are used to burn off the haemorrhoids.
• Cryosurgery – liquid nitrogen is used to freeze off the haemorrhoids.
• Haemorrhoidectomy – often used to treat internal haemorrhoids. The patient is placed under general anaesthetic. The surgeon inserts a special device into the anus so that the haemorrhoids can be seen. The haemorrhoids are removed using a scalpel, laser or staple gun. The membranes lining the rectum and anus are then sewn to the underlying muscle to prevent the recurrence of haemorrhoids.

• You will be placed onto your back with a support. There may be a floatation pillow under your buttocks. Alternatively, you may be advised to lie on your stomach.
• Icepacks or warm wet compresses are sometimes applied to the anal area for pain relief.
• Mild bleeding may occur.
• Regular checks of the operation site will be carried out by nursing staff.
• Regular sitz (salt water) baths (involving sitting in a large basin or bath with warm water) will help to clean the area and provide relief.
• Pain-killing injections are given for the first day or so, then pain-killing tablets.
• Stool softeners may be given to help you achieve a bowel motion two days or so after the operation. Passing a normal bowel motion as soon as possible helps you to re-establish a regular elimination pattern. You should let the nursing staff know if you are about to use your bowels for the first time after the operation, just in case you experience any pain.

• Excessive bleeding
• Infection
• Ongoing pain and discomfort.

• Follow the dietary hints.
• Avoid constipation by eating adequate fruit and fibre.
• If you need some help to move your bowels, use an over-the-counter laxative preparation.
• Drink six to nine glasses of water each day.
• Take a sitz bath after every bowel motion to keep the area clean.

• Change of diet, including plenty of water and fibre
• Soothing creams
• Suppositories
• Stool-softening medication.

• Your doctor

• Haemorrhoids (piles) are varicose veins that occur inside, on or just outside the anus.
• Large haemorrhoids that are visible outside the anus and are painful and itchy are often treated surgically with a procedure called a haemorrhoidectomy.
• Apart from surgery, other forms of treatment for haemorrhoids include dietary changes, creams, suppositories and stool-softening medication.

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