Haemorrhoidectomy
Also known as: haemorrhoid removal surgery, piles removal
A haemorrhoidectomy is a surgical procedure to remove severe or persistent haemorrhoids, especially when non-surgical treatments have failed.
What is it?
When facing persistent haemorrhoid symptoms that refuse to improve with non-surgical treatments, a haemorrhoidectomy might be your best treatment option. This procedure can address severe pain and rectal bleeding, which are common symptoms of haemorrhoids. Typically performed under general anaesthesia, it lasts about 45 minutes and involves local anaesthesia to manage pain during the surgery.
Post-surgery, patients often experience significant swelling that can mimic the presence of haemorrhoids, and the initial days of recovery can be quite painful. Therefore, a high-fibre diet is recommended to ease bowel movements and reduce discomfort. Despite the initial pain, the surgery significantly alleviates the issues caused by haemorrhoids.
Understanding what to expect from a haemorrhoidectomy can help you prepare both physically and mentally. This procedure is often the last resort after other treatments have failed, but it offers a high success rate in alleviating the severe symptoms of haemorrhoids. Familiarising yourself with the procedure and recovery can help you approach the surgery confidently and prepared.
Understanding Haemorrhoids
Haemorrhoids are swollen blood vessels in the lower rectum and anus that can cause significant discomfort and other symptoms. Internal haemorrhoids occur inside the rectum, while external haemorrhoids develop under the skin around the anus. These swollen veins can lead to symptoms such as rectal bleeding, itching, and pain, which vary in severity depending on the individual and the type of haemorrhoid.
Internal and external haemorrhoids, often painless, can cause bright red blood during bowel movements, while external haemorrhoids can be quite painful and may bleed if irritated. Prolapsed internal haemorrhoids can extend outside the anus, leading to additional discomfort and complications. Recognising these differences helps in identifying symptoms and seeking the right treatment.
Most haemorrhoid symptoms can be managed with non-surgical treatments, but when these methods fail, surgical intervention may be necessary. Haemorrhoidectomy is a common surgical procedure aimed at relieving the pain and bleeding associated with severe haemorrhoids.
Causes and Risk Factors of Haemorrhoids
Knowing the causes and risk factors of haemorrhoids helps in both their prevention and treatment. Common causes include excessive pressure on the veins in the pelvic and rectal area, often due to straining during bowel movements or prolonged sitting. This pressure can cause the veins to swell, leading to the development of haemorrhoids.
Pregnancy is another significant cause of haemorrhoids, as the increased pressure from the growing foetus can affect the anal and rectal veins. Additionally, as individuals age, the tissues supporting the rectal and anal veins can weaken, increasing the risk of haemorrhoids. Other risk factors include obesity, which adds pressure to the rectal veins, and activities such as heavy lifting or anal intercourse, which can also elevate the risk.
Recognising these causes and risk factors allows for proactive steps to prevent haemorrhoids. Reducing risk involves maintaining a healthy weight, avoiding prolonged sitting, and managing constipation through diet and hydration.
Hospital fee guide price: £2,380
Procedure price subject to bespoke quotation
*Additional consultant fee not included
Before treatment
Diagnosing haemorrhoids typically involves taking a detailed medical history and conducting a physical examination. For external haemorrhoids, a visual examination is often sufficient to identify the swollen veins or fissures around the anus. This can help in determining the presence and severity of haemorrhoids and in planning the appropriate treatment.
In cases of internal haemorrhoids, a digital rectal exam is usually performed. During this exam, the patient lies on their side or leans over an examination table while the healthcare provider inserts a lubricated finger into the rectum to check for abnormalities. An anoscope may also be used to get a better view of the anal canal.
A combination of medical history, physical examination, and digital rectal exam aids in accurately diagnosing haemorrhoids.
There are various treatment options available for haemorrhoids, ranging from home remedies to medical procedures. The choice of treatment depends on the severity of the symptoms and the type of haemorrhoids.
Home treatments are usually the initial step, but severe cases may require medical procedures.
Home Treatments
Home treatments play a significant role in managing haemorrhoids and preventing their recurrence. Dietary changes, such as increasing the intake of fresh fruits, vegetables, and high-fibre foods, are crucial for maintaining healthy bowel movements and preventing constipation. Staying hydrated and using stool softeners can also help maintain soft stools, reducing the risk of straining during bowel movements.
In addition to dietary changes, other home treatments include taking warm baths to soothe the anal area and applying topical ointments to reduce pain and inflammation. These non-surgical methods are often effective in managing symptoms and preventing further complications related to haemorrhoids and can also help to treat haemorrhoids.
Medical Procedures
When home treatments are not sufficient to relieve haemorrhoid symptoms, medical procedures may be necessary. One common procedure is infrared coagulation, which uses infrared light to coagulate the haemorrhoid tissue, reducing its size and symptoms. Injection sclerotherapy is another minimally invasive procedure, where a chemical solution is injected into the haemorrhoid to cause a fibrotic reaction, leading to the haemorrhoid’s shrinkage and eventual disappearance. These procedures offer effective treatment options for individuals with haemorrhoids that do not respond to home treatments.
For severe cases, surgical procedures like haemorrhoidectomy may be required to remove the haemorrhoids and provide relief from persistent symptoms. Consulting with a consultant colorectal surgeon can help determine the best treatment option based on the individual’s condition and needs.
Haemorrhoidectomy: Surgical Removal of Haemorrhoids
A haemorrhoidectomy is a surgical procedure specifically aimed at removing haemorrhoids when other treatment methods have failed. This surgery is designed to alleviate symptoms such as pain, discomfort, and bleeding associated with haemorrhoids. Individuals experiencing distressing symptoms from haemorrhoids should consult with a specialist to explore haemorrhoidectomy as a treatment option.
The traditional surgical procedure for treating severe haemorrhoids involves cutting away the haemorrhoid tissue.
During treatment
Preparing for Haemorrhoid Surgery
Preparing for haemorrhoid surgery involves a comprehensive medical evaluation to review the patient’s medical history and conduct any necessary diagnostic tests. Before the procedure, specific preoperative instructions are given, which may include dietary restrictions and adjustments in medication. Haemorrhoidectomy is typically indicated for grade III and IV haemorrhoids or when other anorectal issues coexist.
Types of Haemorrhoidectomy
There are different types of haemorrhoidectomy, each with its own techniques and benefits. The two main types are excision and banding, both of which are effective in treating severe haemorrhoids.
Excision
The excision technique involves surgically removing the haemorrhoids using instruments like scalpels or energy devices for precise cutting. This method can be categorised mainly into closed and open types. Closed haemorrhoidectomy, the most commonly performed procedure, has a high success rate of 95%. Open haemorrhoidectomy may be used when closing the incision poses challenges or if there is a high risk of infection. Patients can typically return to work within 7–10 days after the procedure, making it a viable option for those needing effective relief from severe symptoms.
Stapled haemorrhoidectomy is another surgical option, particularly for prolapsed internal haemorrhoids. This method uses a circular stapling gun to pull the haemorrhoids back into place and shrink them, resulting in less postoperative pain compared to traditional methods.
Recovery after excision surgery involves managing pain and following postoperative instructions from the healthcare provider.
While excision can be an effective way to treat severe haemorrhoids, it is important to prepare for the postoperative pain, which can be significant. Pain management strategies and following the healthcare provider’s instructions are crucial for a smooth recovery.
Banding
Banding, or rubber band ligation, is a minimally invasive approach where a rubber band is placed around the base of the haemorrhoid to cut off its blood supply. This procedure is typically performed in an outpatient clinic and has a high success rate, with about 80% of cases being cured. The haemorrhoid dies and drops off within a few days following the banding treatment.
However, potential complications from banding treatment include bleeding, infection, ulcers, or urinary problems. Despite these risks, banding remains a popular and effective treatment option for many patients with haemorrhoids.
After treatment
Post-surgery care is crucial for a successful recovery. It involves managing pain, preventing infections, and ensuring proper healing.
The recovery period can range from two to four weeks, with significant pain reported during the first few days.
Immediate Post-Surgery Care
Strategies for reducing pain include using local anaesthesia during surgery and applying topical ointments. Pain levels can vary widely, often intensifying with the first bowel movement after the procedure. Managing pain effectively with prescribed medication is essential for a smooth recovery.
Sitz baths are recommended several times a day to help with recovery and comfort. Keeping the surgical area clean using water and gentle cleaning methods instead of harsh soaps is also important. Following these immediate post-surgery care tips can significantly aid in the healing process.
Long-Term Recovery
Maintaining hydration and avoiding straining during bowel movements are essential for preventing complications during recovery. Using laxatives post-surgery helps to maintain soft stools, reducing the strain during bowel movements.
Engaging in heavy lifting or strenuous activities should be avoided for at least a week following surgery. Full recovery from haemorrhoid surgery typically requires about four weeks. By following these guidelines, patients can ensure a successful and smooth long-term recovery.
Potential Complications and How to Manage Them
Complications from a haemorrhoidectomy can include excessive bleeding and infections. Post-surgery bleeding can occur, especially after bowel movements, and may last up to a month. Experiencing pain or discomfort in the rectal area is common after a haemorrhoidectomy.
Preventing Future Haemorrhoids
Preventing future haemorrhoids involves making lifestyle changes and adopting healthy habits. Avoid straining on the toilet and respond promptly to the urge to defecate to prevent haemorrhoids.
Limit time spent on the toilet to 10-15 minutes. Avoid behaviours that worsen haemorrhoids, such as ignoring the urge to go and using painkillers that cause constipation. By following these tips, you can significantly reduce the risk of developing haemorrhoids in the future.
Appointment and Treatment Plan
Appointment
Based on your previous consultation with a doctor, an appointment will be arranged between you and your surgeon.
Treatment plan
During this appointment, you will review your medical history, discuss the details of the surgery and recovery process, and collaboratively decide if this procedure is a suitable option for you.
Pre-op assessment
If surgery is an option, then the surgeon and their team will thoroughly assess whether you’re right for the surgery. They’ll consider your current health, any previous issues, and other external matters.
Surgery
Prior to going through the surgery, our team will ensure that you’re prepped once again. If everything is confirmed, you’ll undergo the surgery and then we’ll explain the aftercare instructions.
Aftercare
If necessary, you’ll stay in a ward for a few hours to ensure that you’re ready to go home after the surgery. However, this may depend on the surgery outcome and whether you need moderate or light assistance.
Follow-Up
You’ll come in a few weeks later and we’ll give you one final check-over to ensure that you’re on track for recovery.
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Hospital fee guide price: £2,380
Procedure price subject to bespoke quotation
*Additional consultant fee not included
FAQs
A haemorrhoidectomy is a surgical procedure performed to remove severe or persistent haemorrhoids that haven’t responded to other treatments. It is typically recommended when conservative measures fail to provide relief.
The symptoms of haemorrhoids typically include rectal bleeding, anal itching, and mild pain. If you experience these symptoms, it may be advisable to consult a healthcare professional.
A haemorrhoidectomy is performed under general anaesthesia by surgically removing the haemorrhoid tissue. This effective approach aims to alleviate pain and discomfort associated with haemorrhoids.
During your recovery from a haemorrhoidectomy, you can expect to manage pain, adhere to a high-fibre diet, and follow post-surgery care instructions. Full recovery generally takes around four weeks.
To prevent haemorrhoids from recurring, focus on avoiding straining during bowel movements, eat a high-fibre diet, stay hydrated, and limit time on the toilet. These measures can significantly reduce your risk.