Hemorrhoidectomy

(Hemorrhoid Removal)

Pronounced: HEM-roy-DEK-tuh-mee
by Daus Mahnke, MD

Definition

A hemorrhoidectomy is an operation to remove hemorrhoids. Hemorrhoids are swollen veins located in or around the anus and rectum. Hemorrhoids can cause discomfort, pain, or bleeding.

Hemorrhoid

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Reasons for Procedure    TOP

Hemorrhoidectomy is used to treat painful, swollen hemorrhoids. The procedure is most often done for the following reasons:

  • Hemorrhoid symptoms do not get better with other therapies
  • Severely bleeding hemorrhoids
  • Hemorrhoid containing a blood clot
  • Hemorrhoids that protrude through the anus

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Infection
  • Bleeding
  • Constipation
  • Recurrence of hemorrhoids
  • Narrowing of the anal canal
  • Loss of bowel or bladder control
  • Adverse reaction to local anesthetic

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic disease such as diabetes or obesity

Other factors that may increase your risk of complications include:

  • Prior anal surgery
  • Bleeding disorders

What to Expect    TOP

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • Rectal exam
  • Anoscopy—the visual examination of the inside of the anus using an anoscope to help keep the sphincter open
  • Sigmoidoscopy—the use of a specialized endoscope to examine the inside of the anus, rectum, and lower intestine

Leading up to the procedure:

  • 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.
  • Talk to your doctor about your medications, even non-prescription medications. You may be asked to stop taking some medications up to one week before the procedure, like:
    • Aspirin or other non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen
    • Blood thinners
    • Anti-platelets

Anesthesia

Your surgery will be done using either:

Discuss these options with your doctor before the day of your surgery.

Description of the Procedure    TOP

An anoscope will be inserted into your anus. The doctor will be able to see the hemorrhoids through the scope.

An incision will be made around each hemorrhoid. The swollen vein inside the hemorrhoid will be tied off so that it does not bleed. The hemorrhoid will then be removed. The wounds will either be stitched closed or left open to heal.

There are other variations of this procedure. Ask your doctor to describe which procedure will be used.

Immediately After Procedure    TOP

You will be monitored in a recovery area for a few hours.

How Long Will It Take?    TOP

About 1-2 hours

How Much Will It Hurt?    TOP

You should not feel pain during the procedure. After the procedure, you might have pain in the area. Ask your doctor about medication to help with the pain.

Post-procedure Care    TOP

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions

Be sure to follow your doctor's instructions, which may include:

  • Do not strain, bear down, or hold your breath during a bowel movement.
  • Do not sit on the toilet for long periods of time.

Complete recovery will take 2-3 weeks. If your hemorrhoids come back, let your doctor know.

Call Your Doctor    TOP

Call your doctor if any of the following occurs:

  • Passing large amounts of blood
  • Signs of infection, including fever and chills
  • Pain that you cannot control with the medications you have been given
  • Constipation or trouble urinating
  • An aching feeling develops in the area between the rectum and the genitals

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Gastroenterological Association
http://www.gastro.org
American Society of Colon and Rectal Surgeons
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:

Hemorrhoids. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated March 21, 2013. Accessed May 23, 2013.
Living with hemorrhoids. American Gastroenterological Association website. Available at:
...(Click grey area to select URL)
Published April 25, 2010. Accessed May 23, 2013.
6/2/2011 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
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.
Last reviewed May 2013 by Marcin Chwistek, MD; Brian Randall, MD
Last Updated: 1/24/2014