Digestive Diseases: Surgery to Treat Hemorrhoids

In many cases, hemorrhoids can be treated effectively with diet, good hygiene, and topical medications. In some cases, though, diet and medicines are not enough. People who do not respond to non-surgical treatments might experience long-term relief through surgery.

Surgical Treatment Options

Surgery should be considered for people with large hemorrhoids that are very painful or bleeding. Here are the options:

Hemorrhoidectomy

Surgery to remove hemorrhoids is called hemorrhoidectomy. During hemorrhoidectomy, the doctor makes incisions around the anus to cut away the hemorrhoids. People undergoing the procedure may be given local anesthesia (the patient is awake though relaxed during the procedure but the area being operated on is made numb) or general anesthesia (the patient is put to sleep during the procedure).

Hemorrhoidectomy is generally an outpatient procedure, and patients usually go home the same day.

While surgery usually relieves the pain, swelling, bleeding, and itching caused by hemorrhoids, a drawback to this procedure is that the incisions are made in a highly sensitive area and might require stitches, which can cause the area to be tender and painful.

The Procedure for Prolapse and Hemorrhoids (PPH)

PPH is a minimally invasive procedure to treat hemorrhoids and/or prolapse, a condition in which the hemorrhoids or anal tissue slips down out of the anal canal. During PPH, a stapler-like device is used to reposition the hemorrhoids and cut off their blood supply. Without blood, the hemorrhoids eventually shrivel and die. This procedure moves the hemorrhoid higher in the anus, where there are fewer nerve endings, thus reducing pain.

Benefits of PPH include:

• Less pain
• Quicker recovery
• Less bleeding and itching
• Fewer complications

Other Options

Other minimally invasive options for reducing the size of or removing hemorrhoids include:

• Laser: A special, precise laser beam is used to burn away hemorrhoidal tissue.
• Rubber band ligation: A rubber band is placed around the base of the hemorrhoid to cut off the blood supply and kill the tissue.
• Sclerotherapy: A chemical solution is injected around the blood vessel that supplies the hemorrhoid to shrink and destroy it.

Although these minimally invasive procedures might result in less pain and fewer complications, hemorrhoidectomy might provide better long-term results. Talk to your doctor to see which procedure is right for you.

What Are the Risks of Hemorrhoid Surgery?

Hemorrhoid surgery is very common and is considered safe. However, every surgery has some risks including:

• Bleeding
• Infection
• Reaction to anesthesia

In addition, patients might have some trouble urinating because the pain following surgery makes it difficult to relax and allow urine to flow. Further, the anal sphincter might be damaged during surgery, which can lead to pain and/or fecal incontinence. Fecal incontinence is the inability to control your bowels, which can lead to the involuntary release of feces or gas.