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:

• Spinal anesthesia —You will be numb from the mid-abdomen down.
• General anesthesia —You will be asleep.

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

Description of the Procedure

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

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

How Long Will It Take?

About 1-2 hours

How Much Will It Hurt?

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

Ask your doctor about when it is safe to shower, bathe, or soak in water. Be sure to follow your doctor's instructions, which may include:

• 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.
• Take pain medication as needed.

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