The majority of haemorrhoids can be treated by very simple methods in the clinic setting and do not require an operation.
The symptoms caused by haemorrhoids include bleeding, pain, itching, discharge and prolapse. These symptoms can be associated with more serious conditions and it is essentail to seek medical advice to confirm the diagnosis and exclude more serious problems.
Surgery for your Haemorrhoids
The operation of haemorroidectomy involves the surgical removal of tissue in the anal canal (back passage). There are usually three columns of tissue, and these columns extend from the skin at the edge of the canal upwards as far as the junction between the anal canal and the rectum (the lowest part of the large bowel). Traditional open surgery involves cutting the skin on the edge of the anal canal as well as cutting the lining of the membrane of the anal canal. Some dissolving stitches are used, but mostly the wounds are left open. This is to allow the anal canal to stretch during the passing of a motion. There will be anything from one to three open wounds at the edge of the canal. These wounds will gradually heal up over the period of 4-6 weeks.
The more modern method of surgery involves passing a special stapling device into the rectum, which removes the haemorrhoids internally, avoiding the painful incisions around the anal canal.
Prior to the Operation.
You should follow instructions about eating and drinking. You will be given a small enema just before the operation, to clear the lower portion of the bowel.
Immediately after the Operation
Local anaesthetic is injected into the area during the operation, so when you wake up you will not have any pain. A small plug of spongy material is inserted into the back passage but this will dissolve and you probably will not be aware of it. There may be some bleeding for which you may need to wear a pad for the first few days after surgery.
The following few days
You may not have your bowels open for two to three days. Please do not worry about this. It is perfectly normal, and is natures way of allowing some healing to take place. You will be given the following medicines:
- Lactulose – a laxative
- Metronidazole – an antibiotic to be taken for 5 days after the operation
- Pain killers
- Lignocaine jelly (local anaesthetic)
You should start a high fibre diet immediately after the operation.
The first bowel action after a traditional open operation was notoriously very painful, but after stapled haemorrhoidectomy there is much less discomfort, and after the first bowel action things should improve. It is helpful to have a warm bath or shower immediately after a bowel action.
Continue to take laxatives for about a week after the operation, but then you should gradually stop. It is vey important that you would pass formed motions and not diarrhoea, as this helps to prevent the anal canal from healing up in a scarred and narrow state. This situation can be very difficult to deal with if it does occur. You may notice several swellings around the outside of the anal canal. These are quite normal, and as the skin heals these swellings will gradually disappear.
You will be given an appointment to be seen in the out patient clinic after the operation, so that a check can be made that healing is taking place in the correct fashion.
