Hemorrhoidectomy

A hemorrhoidectomy is surgery to remove hemorrhoids. Hemorrhoids are swollen veins around the outside or inside of the rectum. Hemorrhoids are usually caused by constipation. Eating a diet low in fiber, not drinking enough water, and not getting enough exercise may cause constipation. Hemorrhoids may cause pain, itching, and bleeding.

Not all hemorrhoids must be removed. Treatment for hemorrhoids usually starts with improving bowel habits, increasing fiber in the diet, drinking more water, and getting regular exercise. If these do not help the hemorrhoids, there are other treatments that may be done. Hemorrhoids are graded on a scale of 1 to 4 with 4 being the worst hemorrhoids. Hemorrhoidectomy is usually only for grade 4 hemorrhoids. It may be done for a grade 3 if other treatments have been tried.

There are many treatments for hemorrhoids. If the internal hemorrhoids are small, a rubber band ligation can be done by putting a tiny rubber band on the hemorrhoid. After several days, it will fall off. Often the person does not even notice when it falls off. Another treatment for a small hemorrhoid is sclerotherapy. With sclerotherapy, a chemical agent is injected into the hemorrhoid, which causes it to shrink. Infrared coagulation can be done using a special device to burn the hemorrhoids.

These treatments are usually done on grade 1 to 3 hemorrhoids in the healthcare provider's office. They cause very little pain and do not take a long time to do.

A hemorrhoidectomy is usually done as an outpatient procedure. A spinal or general anesthesia is used. With a spinal, the person is numb from about the waist down. With general anesthesia, the person goes to sleep. The effects of the anesthesia are reversed when it is time for the person to wake up. Sometimes a local anesthetic may be used to numb the area around the rectum. This is the same type of medicine a dentist uses. The person having a hemorrhoidectomy will need to be at the hospital or outpatient center several hours before the surgery is scheduled.

The person will be told not to eat or drink anything, even water, for 8 to12 hours before the surgery. Blood and urine tests may be done several days before surgery or the day of surgery. The person may be given a laxative to take the evening before the surgery. An enema may be given just before surgery. The area around the anus and rectum will be prepared for surgery.

The person is usually allowed to go home the same day as the surgery. They will be told what to expect at home. Instructions may include the following:

• take pain medication
• remove the dressing the evening of the surgery
• sit in a tub of warm water several times a day
• keep dressings on the wound for several days, until there is no more drainage
• take a stool softener to prevent constipation and
• when to start eating and what to eat

Although this surgery is considered to be a minor procedure, some complications that could occur include:

• severe pain (especially with bowel movements)
• constipation
• infection
• bleeding
• inability to urinate and
• return of the hemorrhoids

The healthcare provider should be called if any of these symptoms occur.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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