A hemorrhoidectomy is a surgical procedure to remove internal and/or external hemorrhoids. Hemorrhoids are swollen veins in the lowest part of the rectum and anus that become irritated. Symptoms for this condition can include bleeding, pain, itching, swelling of the anus, burning, and irritation. For many, the cause is unknown but is often associated with increased pressure on the veins from straining bowel movements or pressure on the anus during pregnancy. There are two types of hemorrhoids:
Internal hemorrhoids occur in the rectum and are not visible, these are usually not painful and often the only sign is blood in the stool from straining bowel movements.
External hemorrhoids occur in the anus and are visible, they are more painful due to increased nerve endings in this area.
Most hemorrhoids can clear up on their own but for persistent, painful and heavy bleeding symptoms a hemorrhoidectomy can provide relief. A hemorrhoidectomy may be necessary if you experience persistent symptoms of bloody stool and severe pain in the rectum/anus. There are various ways to surgically treat the hemorrhoids and most people go home the same day of their surgery.
Pre-Op Evaluation and Prep:
You will schedule a consult with a Colorectal Surgeon to discuss treatment options as there are various ways to perform a hemorrhoidectomy. Routine blood work and x-ray studies may be ordered prior to surgery based on the patient's age and the presence of any existing medical problems.
You may be instructed to stop taking some medications before surgery including aspirins and other blood thinning medications. Make sure your surgeon knows all the prescription and over-the-counter medications you take, including natural or nutritional supplements.
Eating and drinking may be limited between 6 and 12 hours before the surgery.If you are preparing for surgery and received instruction about a clear liquid diet or a high fiber diet, the instructions are attached below for your ready access. For more information related to preparation for surgery click here.
A hemorrhoidectomy is a surgical procedure generally performed under general anesthesia so you will not feel anything. There are several different ways to perform a hemorrhoidectomy. Talking to your Colorectal Surgeon will ensure the best procedure for your individual needs.
Recovery may vary from patient to patient. Most patients are back to desk type work within a few days. It typically takes about 2 to 3 weeks to fully recover and return to strenuous activity. While recovery instructions may be tailored to individualize a plan of care based upon your specific needs, these instructions are common following hemorrhoidectomy procedures:
- You will need to arrange for a ride home the day of your surgery and we recommend someone stay with you for the first 24 hours at home.
- Avoid fried foods, milk products, and citrus juices for around one day after your procedure. Suggestions for foods to eat include soup, sandwich, pasta, potatoes, toast and applesauce. Otherwise, there are no long-term dietary restrictions after this procedure.
- When you leave the facility after surgery, you will want to go home and rest. Avoid making any other plans on the day of your surgery. Starting the following day, you can increase your activity as you feel up to it. Avoid lifting anything heavier than a gallon of milk for 48 hours following your procedure.
- Although you are likely to feel completely numb for several hours after the procedure, you will be given a prescription for pain medication following your procedure. Oftentimes we will recommend taking Tylenol and Advil (same as Motrin, Ibuprofen) or Aleve in addition to the narcotic pain medication. The recovery nurse will discuss a pain control plan with you specific to you and your needs and we recommend you follow the pain control plan for at least the first few days following your procedure. Make plans to avoid driving for at least 4 hours after taking a prescription pain pill.
- Some additional home comfort measures include:
- Plan to take warm baths as often as possible. Warm baths, also called sitz baths, increase blood flow and help relax the muscles in the area of your procedure in addition to keeping the area clean.
- You should also plan to begin taking Miralax and stool softeners starting the day after your procedure each day and until you are no longer taking pain medication.
- Find a fiber supplement you like and take it every day. We recommend FiberCon tablets. For more information on fiber, please see the information here.
- It is common to notice drainage after the procedure. Bleeding is natural with your first bowel movement and with any strain on the area. Lying down will often help stop bleeding, which should resolve in its own within a few hours. We recommend having gauze pads or hygiene pads available as needed for the first week after the procedure.
- Most patients are scheduled for a follow up appointment around 4 weeks after the procedure, although our team is available for any questions or concerns that might develop before that appointment.
For additional information for after surgery preparation click here.
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