Hemorrhoids are swollen veins around the anus. They may be inside the anus or outside the anus.
Often hemorrhoids do not cause problems. However, if hemorrhoids bleed a lot or cause pain, hemorrhoid surgery can remove them.
Hemorrhoid surgery can be done in your doctor's office or a clinic. In most cases, you can go home the same day. The type of surgery you have may depend on your symptoms and the location and size of the hemorrhoid.
Before the surgery, your doctor will numb the area so you can stay awake, but not feel anything. For some types of surgery, you may be given general anesthesia. This means you will be given medicine in your vein that puts you to sleep during your surgery.
Hemorrhoid surgery may involve:
- Putting a small rubber band around a hemorrhoid to shrink it by blocking blood flow
- Stapling a hemorrhoid to block blood flow, causing it to shrink
- Using a knife (scalpel) to remove hemorrhoids. You may or may not have stitches.
Other methods include injections and use of infrared light, but these may be less effective.
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Why the Procedure Is Performed
Often you can manage small hemorrhoids by:
- Eating a high fiber diet
- Drinking more water
- Avoiding constipation (taking a fiber supplement if needed)
- Not straining when you have a bowel movement
If lifestyle changes don't work and you are having bleeding and pain, your doctor may recommend hemorrhoid surgery.
Risks for this type of surgery include:
- Leaking a small amount of stool (long-term problems are rare)
- Problems passing urine because of the pain
Before the Procedure
Several days before surgery, you may be asked to stop taking drugs that make it hard for your blood to clot. These drugs include:
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve, Naprosyn)
- Warfarin (Coumadin)
- Clopidogrel (Plavix)
Be sure to tell your doctor:
- What medicines you are taking. Be sure to include all over-the-counter medicines, supplements, or herbal remedies.
- About any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.
On the day of your surgery:
- You will usually be asked not to drink or eat anything for 6 - 12 hours before your surgery.
- Take any drugs your doctor told you to take with a small sip of water.
- Your doctor will tell you when to arrive at the hospital and what to bring.
After the Procedure
You will usually go home the same day after your surgery. Be sure you arrange to have someone drive you home. You may have a lot of pain after surgery as the area tightens and relaxes. You may be given medications to relieve pain.
Your health care provider will tell you how to care for yourself.
Most people do very well after hemorrhoid surgery. You should have a complete recovery in about 2 weeks.
You will need to continue with diet and lifestyle changes to help prevent the hemorrhoids from coming back.
Melton, GB. Hemorrhoids, anal fissure, and anorectal abscess and fistula. In: Bope & Kellerman: Conn's Current Therapy. 1st ed. St. Louis, MO: W.B. Saunders Elsevier; 2013:chap 8.
Zainea GG, Pfenninger JL. Office Treatment of Hemorrhoids. In: Pfenninger: Pfenninger and Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 106.