What is a haemorrhoidectomy?

A haemorrhoidectomy is an operation to remove severe haemorrhoids (also known as 'piles'). The procedure is common and generally safe.

It is usually a day procedure carried out under a general anaesthetic. Recovery can take a few weeks and can be painful.

Haemorrhoids are lumps that occur in and around the anal canal (anus or back passage).

Read more about haemorrhoids.

When is a haemorrhoidectomy needed?

Most haemorrhoids can be treated with medicines or non-surgical procedures.

Your doctor might suggest a haemorrhoidectomy if your haemorrhoids are large or complicated, or if non-surgical treatments do not work.

Removing the haemorrhoids can relieve your symptoms, but haemorrhoids can return. You can help prevent haemorrhoids returning by eating a healthy diet and exercising.

Some people may prefer surgery to other interventions. It is important to talk to your doctor about the benefits and risks of surgery.

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What are the benefits of a haemorrhoidectomy?

The benefits of haemorrhoidectomy compared with non-surgical treatment are:

• faster symptom relief
• your haemorrhoids are less likely to come back
• longer time without haemorrhoids

What does a haemorrhoidectomy involve?

A haemorrhoidectomy is performed under a general anaesthetic, so you will not be awake during the surgery.

There are several types of haemorrhoidectomy procedures:

• Haemorrhoidectomy — the haemorrhoids are cut away.
• Stapled haemorrhoidectomy — the haemorrhoids can be pulled back inside your rectum and stapled in place.
• Transanal haemorrhoidal de-arterialisation (THD) — the arteries supplying blood to your haemorrhoids are closed, which helps them shrink.

How do I prepare myself for a haemorrhoidectomy?

Follow the guidelines your doctor gives you on how to prepare for the procedure.

You will be asked to fast (not eat or drink) for some time before you arrive at the clinic.

If you usually take blood-thinning medicines, you might be asked to stop taking them some days before the procedure. Always check with your doctor before you stop taking a medicine.

You might also be asked to use an enema (where liquid is inserted into your anus) or a laxative to empty out your bowel.

Learn more about how to prepare for surgery.

Recovering from a haemorrhoidectomy

After surgery, you will likely have pain, especially when opening your bowels. You might also have some bleeding.

Follow all instructions from your healthcare team.

Recovery

Many people go home the same day as the operation. Make sure that you arrange for someone to pick you up from hospital. This is because you cannot drive straight after a general anaesthetic.

The general anaesthetic might make you feel sick and tired for a few days.

You may need to take 1 to 2 weeks off work to recover.

Avoid constipation

It is important to avoid constipation. Drink plenty of water and eat a healthy diet that is high in fibre, fruit and vegetables.

You may be asked to take laxatives, such as stool softeners. These will help to reduce discomfort when you empty your bowels (poo).

Pain control

Your doctor will give you a plan for managing your pain. This may include simple pain relief (paracetamol or ibuprofen). Sometimes you may need stronger pain relief medicine.

Call your doctor if the pain around your anus (back passage) gets worse rather than better.

Follow-up

Your doctor will probably ask you to return for a check-up sometime after your operation.

What complications can happen?

A haemorrhoidectomy is a common and generally safe procedure. But there can also be complications. These include:

• bleeding too much
• difficulty urinating (weeing)
• infection, which may cause a high temperature (fever)
• loss of control of the muscle that controls the opening of the anus (soiling)
• narrowing or damage to your anal canal

Call your doctor if you have any of these symptoms.

Are there alternatives to a haemorrhoidectomy?

Haemorrhoid treatment depends on where the haemorrhoids are located and how severe your symptoms are. A haemorrhoidectomy is effective for severe haemorrhoids.

Other treatments that do not involve surgery are suitable for less severe haemorrhoids. These include:

• infrared treatment (photocoagulation)
• rubber band ligation (banding)
• injection (sclerotherapy)
• local creams and lifestyle changes

To find out more about these treatments read the article about haemorrhoids.

What will happen if I decide not to have the procedure or it is delayed?

If surgery is postponed or not performed, haemorrhoids may continue to cause discomfort such as bleeding, swelling or irritation.

In some people, symptoms gradually get worse, for example when haemorrhoids are large or complicated.

Less invasive options can provide relief for mild cases, but they are not as effective for severe haemorrhoids.

Waiting generally does not usually cause serious health problems, but ongoing pain or bleeding may mean you need repeated treatments or medicines.

Persistent haemorrhoids can sometimes lead to problems such as anaemia from ongoing blood loss. It can also be hard to keep the area clean.

Your doctor can help you decide if delaying surgery is reasonable in your situation and discuss other ways to manage symptoms while you wait.

Resources and support

Visit the Colorectal Surgical Society of Australia and New Zealand website to learn more about haemorrhoids.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.