The type of treatment for haemorrhoids varies depending on the size of the haemorrhoids - if they are small or moderately sized, the most appropriate treatment is generally 'rubber band ligation' (simply referred to as 'banding'). Where the haemorrhoids are large or complex, the preferred approach is normally a haemorrhoidectomy, that is surgical removal.
This is carried out as a standard surgical procedure under general anaesthetic. The operation normally takes around 40 minutes and the patient is generally able to return home the same day, after a short period of observation. Patients are strongly advised not to drive themselves home after the procedure and to return home to rest and not go back to work, as the full effects of the anaesthetic will take the rest of the day to dissipate.
How should I prepare for surgery?
The day before admission we will contact you to confirm admission time and to give you instructions regarding any fasting requirements for the procedure. Ensure you bring any current medication in with you to the hospital.
For day procedures you should not drive yourself home when you are discharged – please ensure you have made other transport arrangements.
If you smoke, you should reduce smoking before your procedure. Our strong recommendation is that you give up entirely at least 6 weeks before the procedure, or at least one week beforehand. Smoking greatly increases the possibility of chest infection and hampers natural wound healing.
In the case of major surgery, please inform Dr White's team if you take:
- Anti-inflammatory medication.
We will need to discuss these medications with you prior to your surgery.
Dr White will provide you with a full set of pre-operative instructions for your specific surgery well ahead of the day of surgery.
What is involved in the procedure?
In most cases, these haemorrhoids are removed. Internally, incisions are closed using stitches, however any external incisions are not stitched and instead are allowed to heal on their own.
This procedure occasionally requires an overnight hospital stay – although some patients can return home on the same day.
Dr White will discuss the details of your hospital stay with you prior to your procedure.
There is often moderate to severe pain after this procedure. There may be some pain once the effects of the local anaesthetic have worn off around two hours after the procedure.
If this is the case we recommend the following combination of Panadol and Ibuprofen for the initial 48-hour period after surgery:
- Two (500mg) Paracetamol tablets every four to six (4-6) hours.
- Two (200mg) Ibuprofen tablets every six to eight (6-8) hours.
If pain continues beyond this period, or if it becomes severe, you should contact your doctor.
In rare cases, this pain relief may not be sufficient – in which case you will need to take stronger pain relief. You will require a prescription for Panadeine Forte – two (500mg) tablets every six to eight (6-8) hours.
Regular salt baths, two to three times a day can provide some pain relief and help keep the wound clean. It's also a good idea to have a salt bath after any bowel movements.
After the procedure you wound/s will be dressed. Stitches are generally not used in this procedure as they can lead to infection. Dressing/s can be removed on the evening of the day of the procedure, but not before. The easiest way to do this is to take a shower or bath and they will come off with a little assistance. Wound/s do not need to be dressed again - wearing an absorbent pad in your underwear should be enough to absorb any fluid coming from the wound. To stop any irritation of the nearby skin you should use a barrier cream (e.g. Bepanthen, Vasoline).
You may experience some pain, and you may see some blood in the toilet bowl or on toilet paper, when having a bowel movement. This may last for up to seven days after surgery. Apart from this there should be no further symptoms. It's important during this early stage to avoid becoming constipated, as this will make the pain worse.
Since a hamorrhoidectomy is a surgical procedure, the recovery time can be anything up to several weeks and pain is normal during this time as the incisions heal.
All types of surgery are subject to the following risks, which are rare, but can occur:
- Allergic reaction to medication / anaesthetic.
- Difficulty breathing.
Risks associated with this procedure, although rare, include:
- Urine retention (difficulty urinating).
- Faecal incontinence.
- Anal fistula development.
- Stenosis (narrowing) of the anal canal.
When you should get in contact with Dr White
Most surgical procedures are uneventful, with minimal complications. However, you need to be aware of the following symptoms as they may indicate a developing serious complication...
- Excess bleeding.
- Difficulty urinating.
- Severe or increasing pain.
If you experience any of these symptoms or have any concerns after your surgery, please contact the rooms on 07 5598 0955 for advice.
A post operative appointment will be made for you before you are discharged from hospital. If you are discharged on a weekend, after normal surgery hours or it is not clear what follow up appointments are required, then contact the rooms the next working day to make an appointment.