Haemorrhoidectomy

What are haemorrhoids?

Haemorrhoids, also known as piles, are soft fleshy lumps just inside the anus (back passage). When large, haemorrhoids can pass through the anus (prolapsed pile), feeling like a lump when you clean yourself.

Haemorrhoids bleed easily, usually causing fresh bright-red blood when a motion is passed. They can also be painful and itchy.

Haemorrhoids develop gradually, often over a long period of time. They are associated with constipation, often run in families, and can be made worse by pregnancy.

Is a haemorrhoidectomy right for me?

Haemorrhoids can often be treated by simple measures such as eating more fibre and drinking more fluid.

Your consultant may recommend a haemorrhoidectomy if:

• lifestyle changes haven't helped
• less invasive methods haven't worked
• your haemorrhoids are severe and causing you a lot of pain.

What happens during a haemorrhoidectomy?

A haemorrhoidectomy is usually performed under general anaesthetic. The procedure takes about 20 minutes.

During the procedure

1. Your surgeon will examine your back passage and lower bowel before removing the haemorrhoids by either cutting them away
2. They'll make sure that the blood vessels that supplied the haemorrhoids have stopped bleeding
3. Finally, they'll apply a dressing, which may be inside your back passage – this dressing will dissolve or fall out when you pass a bowel movement.

After the procedure

Afterwards you'll be taken to the recovery room where you'll wake up. You shouldn’t feel any pain, but you might be groggy and slightly uncomfortable as you come around. 

Recovery from haemorrhoidectomy

Most people make a good recovery and return to normal activities after around 2–3 weeks. 

Short-term recovery

Back in your room, the nurses will monitor you check your wound. You can expect some bleeding – the healthcare team will give you pads to wear. They'll also provide you with painkillers. 

You should be able to go home on the day of the operation, but sometimes you may need to stay a little longer. 

If you do go home the same day, first 24 hours:

• you’ll need someone to take you home and stay with you overnight
• don’t drive, operate machinery, or do any potentially dangerous activities (like cooking) until you’ve fully recovered feeling, movement and co-ordination
• you shouldn’t sign legal documents or drink alcohol.

Managing your recovery at home

You should get plenty of rest for the first 24 hours, but then it’s important to stay active to avoid blood clots. You should also follow the instructions from our healthcare team on medication or special compression stockings.

You'll normally have a bowel movement within 2–3 days of the procedure, which may be uncomfortable, but will improve over time. You may also have bleeding after opening your bowels, but this will gradually go down over the next few weeks.

The open wounds can take 2–3 weeks to heal. During this time, they can be painful and may bleed or leave a discharge.

Here are a few things you can do to make sure you recover well:

• Take any pain relief medication as prescribed
• Drink plenty of fluids and increase the amount of fibre in your diet
• Take any laxatives we've prescribed to keep your stools soft
• Keep wearing pads until your wounds have healed
• Having sitz baths (a shallow bath with plain warm water) after each bowel movement can help to clean the area as well as discomfort
• Exercise regularly.

Time off work

You should be able to return to work within 3–4 weeks, depending on your type of work and how you feel.

Follow-up appointments

You'll need to come back to the clinic after about a week so the healthcare team can check your wounds.

Complications of haemorrhoidectomy

As with any surgery, there's a small chance of complications, such as:

• pain
• bleeding
• infection of the surgical site
• blood clots

Specific complications of a haemorrhoidectomy can include:

• incomplete haemorrhoidectomy
• difficulty passing urine
• anal stenosis
• developing skin tags
• developing an anal fissure
• faecal incontinence.

The healthcare team will do their best to minimise any risks. Make sure you discuss any concerns you have about these complications with your consultant.