Haemorrhoidectomy

The term, “hemorrhoids” or (piles) refers to groups of blood vessels in the anorectal area which are present in everyone. However, patients become symptomatic from difficulties with their hemorrhoids. There are two types of hemorrhoids: internal and external. This distinction is important, because of the possible symptoms and treatment alternatives. The division is marked anatomically by the dentate line, which embryologically delineates where skin-type structures meet with rectal lining structures. Importantly, there are many nerve endings for pain distal (beyond) to this line, where the external hemorrhoids are, whereas proximal (in front) to this line, there are no pain fibers.

Symptoms of that lead to haemorrhoidectomy are:

  • Feeling of needing to empty your bowels, even when they are empty
  • A hard lump around your anus
  • Itchiness and discomfort around your anus
  • Bleeding after you have passed a stool
  • Excessive straining and pain when delivering a stool
  • A pus discharge after passing a stool

The procedure is performed under general anaesthesia. The haemorrhoidal tissue is literally cut away, taking care not to damage the delicate muscles of the back passage. There are commonly 3 haemorrhoidal masses, located in the 3, 7 and 11 o’clock positions. After cutting away each pile, the blood vessels are tied with a strong thread. The threads are left hanging long so that they can be examined later if necessary and can sometimes be felt by the patient. The wounds themselves are not usually stitched but left to heal from underneath, a process which takes 3-4 weeks

Complications after haemorrhoidectomy are:

  • a high temperature
  • increasing pain
  • excessive bleeding
  • severe pain after a bowel movement
  • no bowel movement for several days

Within a few hours of the operation, you will be encouraged to get up and walk around, with assistance if required. You may eat and drink normally, and we recommend a high-fibre diet, and lots of fluids. You can leave the hospital on the same day or on the following day. You should expect to pass faeces within two to three days, and this might be uncomfortable at first. A small amount of bleeding is expected. Over the first few weeks, you might notice some change in your ability to control wind, which will resolve. Provided you feel comfortable, there are no restrictions on your normal activity and you may lift things, drive and go back to work.

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