Hemorrhoidectomy
(Hemorrhoid Removal)
Definition
| Hemorrhoid |
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Reasons for Procedure
- Hemorrhoid symptoms do not get better with other therapies
- Severely bleeding hemorrhoids
- Severely painful hemorrhoids
- Hemorrhoid containing a blood clot (thrombosed hemorrhoid)
- Hemorrhoids that protrude through the anus (prolapsed hemorrhoids)
Possible Complications
- Infection
- Bleeding
- Constipation
- Recurrence of hemorrhoids
- Narrowing of the anal canal
- Loss of bowel or bladder control
- Adverse reaction to local anesthetic
- Smoking
- Bleeding disorder
- Advanced age
- Prior anal surgery
What to Expect
Prior to Procedure
- Physical exam
- Rectal exam
- Anoscopy—the visual examination of the inside of the anus using a short tube (anoscope) to help keep the sphincter open
- Sigmoidoscopy —the use of a specialized endoscope (a tube attached to a viewing device) to examine the inside of the anus, rectum, and lower intestine
- Do not eat or drink anything after midnight.
- Your doctor will order a laxative for you. It will cleanse your colon and rectum.
- Arrange for someone to take you home after the surgery.
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Talk to your doctor about your medicines, even non-prescription medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, like warfarin (Coumadin) or heparin
- Clopidogrel (Plavix)
Anesthesia
- Spinal anesthesia —You will be numb from the mid-abdomen down.
- General anesthesia —You will be asleep.
Description of the Procedure
Immediately After Procedure
How Long Will It Take?
How Much Will It Hurt?
Post-procedure Care
- If your doctor says it is okay, take sitz baths as recommended. Sitz baths will help relieve discomfort and clean the area. For a sitz bath, sit in warm water for 10-15 minutes. Pat the area dry. Do not wipe or rub vigorously. You may be advised to take a sitz bath every four hours and after every bowel movement. Devices are available to place on top of the toilet to make this process easier.
- Move your bowels as soon as you feel the urge.
- Do not strain, bear down, or hold your breath during a bowel movement.
- Do not sit on the toilet for long periods of time.
- To prevent constipation and straining during bowel movements, use a stool softener, exercise, drink plenty of fluids, and eat plenty of high-fiber foods ( fruits, vegetables , beans, and whole grain ).
- Apply creams or ointments as directed by your doctor.
- Avoid heavy lifting for two or three weeks.
- Use stool softeners.
- Take pain medicine as needed.
Call Your Doctor
- Passing large amounts of blood
- Signs of infection, including fever and chills
- Pain that you cannot control with the medicines you have been given
- Constipation or trouble urinating
- An aching feeling develops in the area between the rectum and the genitals
RESOURCES
American Gastroenterological Association http://www.gastro.org/
American Society of Colon and Rectal Surgeons (ASCRS) http://www.fascrs.org/
CANADIAN RESOURCES
The Canadian Association of Gastroenterology http://www.cag-acg.org/
The College of Family Physicians of Canada http://www.cfpc.ca/
References
Khatri VP, Asensio JA. Operative Surgery Manual. Philadelphia, PA: WB Saunders; 2003.
Townsend CM. Sabiston Textbook of Surgery. 17th ed. St. Louis, MO: WB Saunders; 2004.
Yamada T. Textbook of Gastroenterology. 4th ed. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2003.
6/2/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
