Haemorrhoidal surgery
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- Surgical options available Haemorrhoidectomy / stapled haemorrhoidectomy
- (haemorrhoidectomy)
- Complications following and during surgery
- General complications of any surgery Pain
- Infection of the surgical site
- Specific complications of the two operations Difficulty passing urine
- Incontinence
- Returning to normal activities and work
- If you require a special edition of this leaflet
- [For the hearing impaired]
Haemorrhoids Haemorrhoids are also known as piles, they are soft fleshy lumps inside the back passage (anus). They have a rich blood supply and can bleed easily, usually causing a fresh bright red bleed after you have had a bowel movement. They do not usually cause pain but can cause itching around the anus, when large they can pass through the anus, (prolapsed pile), feeling like a lump when you clean yourself. Haemorrhoids develop gradually, often over a long period of time. They are associated with constipation, particularly if you need to strain to open your bowels. They can be made worse by pregnancy. Haemorrhoids can often be successfully treated by simple measures such as making sure your motions are bulky and soft, and that you do not strain while opening your bowels. Eating more fibre and drinking more fluid usually improves the way your bowel work. Local treatments aimed at shrinking the haemorrhoids can be successful. Only when the surgeon has tried other treatments and ruled out other causes of your symptoms, they will decide on surgical intervention. Surgical options available Haemorrhoidectomy / stapled haemorrhoidectomy These two surgical procedures are performed under a general anaesthetic; however your anaesthetist will discuss the options available and recommend the best anaesthesia for you. You may be given antibiotics during the operation to reduce the risk of infection. Your surgeon will examine your back passage and lower bowel; the haemorrhoids can either be removed by cutting them away (haemorrhoidectomy) or using a staple gun, (stapled haemorrhoidectomy). Your surgeon will make sure that the blood vessels that supplied the haemorrhoids have stopped bleeding. What should I do about my medication? You should make sure your surgeon knows what medication you are on and always follow there advice. If you take warfarin or clopidogrel it may be that you need to stop these prior to the operation. If you are a diabetic, it is important that your diabetes is controlled around the time of your operation. You must follow the advice from your surgeon regarding your medication. If you are taking beta-blockers to control your blood pressure, you should continue to take your medication as normal. Complications following and during surgery The health care team will try to make your operation and recovery as safe as possible, however complication can happen, some of these can be serious and can even cause death. You will have a discussion with your anaesthetist prior to you operation. General complications of any surgery Pain A haemorrhoidectomy and stapled haemorrhoidectomy can be painful, the local anaesthetic and pain killing medication will help to keep you comfortable, the pain can continue for two/three weeks while the raw areas in your back passage heal. The pain my be less if a staple gun is used, you will also require medication to keep your motions soft. Bleeding after surgery, if the blood vessels start to bleed again soon after surgery, you may need another operation to stop the bleeding (risk less than 1 in 100). If your haemorrhoids were cut away (haemorrhoidectomy) bleeding may happen one to two weeks after surgery; however this usually settles down on its own. If you do have heavy bleeding you must seek advice urgently. Infection of the surgical site (wound). Try to have a bath or shower either the day before or day of surgery this will reduce the risk of infection. After your operation if you get a temperature, notice pus in your wound, or if it becomes red, sore or painful you must seek advice and the specialist nurse number is at the bottom of the leaflet. An infection usually settles with antibiotics, but occasionally you may need another operation. Blood clots in the legs which occasionally move through the bloodstream to the lungs making it difficult for you to breathe. The nurse looking after you will strongly encourage you to get out of bed very soon following surgery, and may give you injections, medication or special stockings to wear. Specific complications of the two operations Difficulty passing urine, which may need a catheter (tube) into your bladder for a day or two. Anal stenosis, where the back passage narrows due to scaring, this may need further surgery. Developing anal skin tags, where small pieces of skin are left at the edge of the anus after the wounds have healed. Developing an anal fissure, which is a tear in the skin around the back passage caused by a wound not healing properly. There are simple treatments for an anal fissure but sometimes surgery is needed. Incontinence this can happen to a minor degree following surgery but this normally would settle, you may need further treatment. Recovery in hospital This is usually a day case procedure, once you have had your operation and you have recovered you will be discharged home that same day, you will either be followed up by the surgeon or the colorectal nurse specialist. You may not see the surgeon again after your operation. Due to you having an anaesthetic, you will have to have a member of your family collect you from the hospital. In some cases the surgeon will keep you in over night and discharged the next day. Recovery at home You should not drive or operate machinery or do any potentially dangerous activities for at least 24 hours post surgery. Your wound often take several weeks to fully heal and you may need to wear pads until then. There are no open wound with a stapled haemorrhoidectomy, but slight bleeding or discharge is common. Once you have recovered from the surgery you will have a follow up with either the surgeon or nurse specialist. Returning to normal activities and work You should be able to return to work with in three to four weeks depending on your type of work. Regular exercise should help you to return to normal activities as soon as possible. Do not drive until you are confident about controlling your vehicle and always check with your insurance company. You should make a full recovery and your symptoms should clear completely, however haemorrhoids can come back. Please read this leaflet carefully and anything you would like to discuss please contact the specialist nurse on the number below. Maxine Handford, Colorectal Clinical Nurse Specialist in Benign Disease Direct line: 0151529 8163 General enquiries: 01515292842 xxxxxx.xxxxxxxx@xxxxxxx.xxx.xx Aintree University Hospitals NHS Foundation Trust is not responsible for the content of any material referenced in this leaflet that has not been produced and approved by the Trust.   
If you require a special edition of this leaflet This leaflet is available in large print, Braille, on audio tape or disk and in other languages on request. Please contact the Patient Advice and Liaison Service [PALS] on: 
  
Telephone Textphone Fax 0151 0151 0151 529 3287 529 2523 529 2019
Si vous voulez cette brochure en français, contactez le bureau des rendez-vous ou demandez à un membre du personnel. 
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Mae’r daflen hon ar gael (ar gais), mewn print bras, ar dâp sain neu ar ddisg, ac efallai mewn ieithoedd eraill ar gais. Cysylltwch â chanolfan apwyntiadau cleifion i ofyn am gopi.
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