About Hemorrhoid Removal
Some procedures shrink or remove them, such as using a laser, which can be done in your doctor's office. However, surgery might be a better long-term decision, especially if your hemorrhoids are large and very painful or bleeding.
What are hemorrhoids?
Hemorrhoids, commonly known as piles, are swollen veins located in the lower part of the rectum and anus. They are akin to varicose veins and can develop internally within the rectum or externally under the skin around the anus. The condition becomes particularly noticeable when these veins are inflamed or swollen, leading to a variety of symptoms and discomforts.
Internally, hemorrhoids may not be visible or cause significant pain, but they can lead to painless bleeding during bowel movements, where one might observe small amounts of bright red blood either on the toilet tissue or in the toilet bowl. In some cases, internal hemorrhoids can protrude through the anal opening, a condition known as prolapsed or protruding hemorrhoids, which can result in pain and irritation.
External hemorrhoids, on the other hand, can be felt as lumps under the skin around the anus and can cause itching, irritation, pain, and swelling in the affected area. In more severe cases, blood can pool in an external hemorrhoid and form a clot, leading to intense pain, inflammation, and a hard, discolored lump near the anus, known as a thrombosed hemorrhoid.
The exact causes of hemorrhoids are not entirely clear, but several factors contribute to their development. These include straining during bowel movements, sitting for prolonged periods (especially on the toilet), chronic diarrhea or constipation, obesity, pregnancy, anal intercourse, a low-fiber diet, and regularly lifting heavy objects. As people age, the risk of developing hemorrhoids increases due to the weakening and stretching of the tissues that support the veins in the rectum and anus.
Why is Hemorrhoid Removal needed?
Hemorrhoid removal, medically referred to as hemorrhoidectomy, is a procedure considered when hemorrhoids cause severe symptoms that do not respond to conservative treatments. The necessity for removal arises from the complications and discomfort that hemorrhoids can cause, impacting the quality of life.
Hemorrhoids are swollen blood vessels in the rectal area that can cause pain, itching, and bleeding. While many hemorrhoids can be managed with dietary changes, topical treatments, and other non-invasive methods, some cases require more definitive treatment. Removal is needed when hemorrhoids become excessively large, cause significant bleeding, or are associated with intense pain, especially if they have thrombosed (developed blood clots).
Persistent hemorrhoids can lead to chronic blood loss and anemia, necessitating removal to prevent further health complications. Additionally, prolapsed hemorrhoids that cannot be manually reinserted back into the anus may require surgical intervention. The presence of strangulated hemorrhoids, where the blood supply is cut off, also warrants immediate removal due to the risk of tissue death and infection.
The decision to remove hemorrhoids is also influenced by the recurrence and persistence of symptoms despite trying less invasive treatments. For individuals who experience frequent flare-ups that interfere with daily activities, removal can provide long-term relief and improve their ability to perform routine tasks without discomfort. Only a small percentage of people with hemorrhoids require surgery. However, if other procedures haven't been successful or you have large hemorrhoids, your doctor might recommend one of the following:
Hemorrhoid removal (hemorrhoidectomy)
The surgery can be done with local anesthesia combined with sedation, spinal anesthesia, or general anesthesia. Hemorrhoidectomy is the most effective and complete way to treat severe or recurring hemorrhoids. Complications may include temporary difficulties with emptying your bladder, which can result in urinary tract infections. The operation is usually done in a surgery center. You will most likely go home the same day (outpatient).
Hemorrhoid stapling
This procedure, called stapled hemorrhoidopexy, blocks blood flow to hemorrhoidal tissue. It is typically used only for internal hemorrhoids. Stapling generally involves less pain than hemorrhoidectomy and allows for an earlier return to regular activities. Complications may also include bleeding, urinary retention, and pain, as well as, rarely, a life-threatening blood infection (sepsis). Compared to hemorrhoidectomy, stapling has been associated with a greater risk of recurrence and rectal prolapse, in which part of the rectum protrudes from the anus.
Hemorrhoid removal side effects
- Slow healing
- Small tears can cause pain that lasts several months
- Narrowing of the anus (stenosis) due to scar tissue
- Damage to sphincter muscles, which can lead to incontinence
- Urinary retention
Hemorrhoid removal recovery
A hemorrhoid surgery usually takes 4 weeks for full recovery, while patients may experience pain or discomfort in their rectal area.