Hemorrhoids are swollen blood vessels that may occur inside the rectum (internal) or outside the rectum (external).
Hemorrhoids can usually be managed by eating a high-fiber diet and drinking eight to ten glasses of water per day. You may also need to use stool softeners to reduce straining during bowel movements. Your doctor may recommend over-the-counter topical ointments to ease occasional itching or irritation.
Sometimes, hemorrhoids can lead to other complications. External hemorrhoids may develop painful blood clots. Internal hemorrhoids may prolapse (drop through the rectum and bulge from the anus). External or prolapsed hemorrhoids can become irritated or infected and may require surgery.
Internal hemorrhoids usually cause no discomfort. They may bleed painlessly after a bowel movement. They become a problem when they bleed too heavily, or when they prolapse.
External hemorrhoids may also bleed after bowel movements. Because they are exposed, they often become irritated and may itch or become painful. Another common complication of external hemorrhoids is the formation of blood clots inside the vessel. While these clots are not usually life-threatening, they can cause sharp, severe pain.
Some types of hemorrhoid surgery can be done in your doctor’s office without anesthetic. Other types of surgery need to be performed in a hospital.
Banding is a procedure used to treat internal hormones. A tight band is placed around the base of the hemorrhoid to cut off its blood supply. Banding usually requires two or more procedures that take place about two months apart. It is not painful, although you may feel pressure or mild discomfort.
This procedure involves injecting a chemical into the hemorrhoid. The chemical causes the hemorrhoid to shrink and stops it from bleeding. Most people experience little or no pain with the shot.
This treatment uses infrared light, heat, or extreme cold to make the hemorrhoid retract and shrink. Most people experience only mild discomfort or cramping during treatment.
A hemorrhoidectomy is used for large external hemorrhoids and internal hemorrhoids that have prolapsed. This procedure usually takes place in a hospital. You and the surgeon will decide on the best anesthesia to use during the surgery. Choices include:
- general anesthesia (puts you into a deep sleep throughout the surgery)
- regional anesthesia (medication delivered by a shot in the back which numbs the body from the waist down)
- local anesthesia (numbs only the anus and rectum)
If you receive local or regional anesthesia, you may also be given a sedative to help you relax during the procedure.
Once the anesthesia takes effect, the surgeon will cut out the large hemorrhoids. When the operation is over, you will be taken to a recovery room for a brief period of observation. Once the medical team is sure that your vital signs are stable, you will be able to return home.
This procedure is sometimes referred to as stapling. It is usually handled as a day surgery and requires general, regional, or local anesthesia. Stapling is used to treat prolapsed hemorrhoids. A surgical staple fixes the prolapsed hemorrhoid back into place inside the rectum and cuts off the blood supply so that the tissue will shrink and be reabsorbed. Stapling recovery takes less time and is less painful than recovery from a hemorrhoidectomy.
You can expect rectal and anal pain after undergoing hemorrhoid surgery. Your doctor will probably prescribe a painkiller to ease the discomfort.
You can aid in your own recovery by:
- eating a high-fiber diet
- staying hydrated by drinking eight to ten glasses of water each day
- using a stool softener so you won’t have to strain during bowel movements
Avoid any activities that involve heavy lifting or pulling.
Some people find that sitz baths help ease post-surgical discomfort. A sitz bath involves soaking the anal area in a few inches of warm water several times a day.
You can expect to make a full recovery within about 14 days.
When you follow up with your doctor, he or she will probably recommend:
- diet changes, such as eating foods high in fiber
- making lifestyle changes, such as losing weight
- adopting a regular exercise program
These adjustments will reduce the likelihood of hemorrhoids recurring.