Haemorrhoid surgery

Haemorrhoids (also known as 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. It is thought that sitting on the toilet with a relaxed anal sphincter (for example, while reading) may also contribute to the development of haemorrhoids.

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

Problems associated with haemorrhoids

Some of the problems associated with haemorrhoids include:

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

Medical issues to consider

Before the operation, you need to discuss a range of issues with your doctor or surgeon including:

• 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.

Surgical procedures

Depending on the procedure, haemorrhoid surgery may be performed using local anaesthetic, general anaesthetic or spinal block. The various procedures include:

• 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.
• Haemorrhoidectomy –used to treat prolapsed 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.

Immediately after the operation

After the operation you can expect:

• You will be placed on 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, then pain-killing tablets.
• Stool softeners may be given to help you achieve a bowel motion two days or so after the operation.

Possible complications of surgery

Possible complications include:

• Excessive bleeding
• Infection
• Ongoing pain and discomfort.

Taking care of yourself at home

Be guided by your doctor or surgeon, but general suggestions include:

• 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.

Long-term outlook

You may experience some degree of discomfort for up to six weeks after the operation. You should have no trouble with exercising, walking or sitting once the first few days are over.

Other forms of treatment

Apart from surgery, other forms of treatment for haemorrhoids include:

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

Where to get help

• Your doctor

Things to remember

• 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, may be 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.

You might also be interested in:

• Haemorrhoids.
  
• Sclerotherapy - varicose and spider veins.
  

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Canberra Hospital

Last reviewed: May 2011

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Haemorrhoids (piles) are varicose veins that occur inside, on or just outside the anus. A procedure (surgery) called a haemorrhoidectomy can treat large haemorrhoids that are visible outside the anus and are painful and itchy. Other procedures include sclerotherapy and ligation.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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