What is a haemorrhoidectomy?

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

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

Haemorrhoids are lumps that occur inside and around the anal canal.

When is a haemorrhoidectomy needed?

Most haemorrhoids can be treated with medicines or non-surgical procedures or avoided. You can help stop haemorrhoids occurring by eating a healthy diet and exercising.

Your doctor might suggest a haemorrhoidectomy if:

• your haemorrhoids are particularly large or complicated
• non-surgical treatments don't work

Removing the haemorrhoids will relieve your uncomfortable symptoms, but haemorrhoids can return.

Some people may prefer surgery sooner rather than later. It's important to talk to your doctor about the benefits and risks of surgery.

How do I prepare for a haemorrhoidectomy?

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

You will be asked to fast (not to eat or drink) some time before admission to 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 take an enema or laxative to empty out your bowel.

Learn more about how to prepare for surgery here.

What happens during a haemorrhoidectomy?

A haemorrhoidectomy is performed under a general anaesthetic, so you won't 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 help them shrink.

Recovering from a haemorrhoidectomy

After surgery, you'll probably be in quite a bit of pain — especially when opening your bowels. You might also have some bleeding.

Follow any directions you are given by your clinic.

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 can't 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's 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 will probably include simple pain relief (paracetamol or ibuprofen).

Sometimes you may need a stronger medication. 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 are the risks of a haemorrhoidectomy?

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

• bleeding too much
• difficulty urinating (weeing)
• infection, which might cause a high temperature
• loss of control of your rectal sphincter (soiling)
• narrowing or damage to your anal canal

Call your doctor if you have any of these symptoms.

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

Alternatives to a haemorrhoidectomy

Haemorrhoid treatment depends on where they are located and how how severe your symptoms are. Haemorrhoidectomy is effective for severe haemorrhoids.

Other treatments, that don't involve surgery, are suitable for less severe haemorrhoids. These include:

• infrared treatment (photocoagulation)
• rubber band ligation (banding)
• injection (sclerotherapy)

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

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 24 hours a day, 7 days a week.