Hemorrhoids are clumps or masses of tissues located within the anal canal which contain blood vessels that sometimes become swollen due to diarrhea, pregnancy, or constipation.
When the blood vessels enlarge (hemorrhoids) it causes itching, bleeding in the rectum, and sometimes infection. If one suffers from any of the symptoms of hemorrhoids and if treatments such as a fiber rich diet, stool softeners, creams and suppositories, medications, and sitz baths do not work, then hemorrhoid surgery should be considered. Surgery should only be the last resort if and only if other treatments do not work. Hemorrhoid surgery can provide a swift solution to the problem, but if and only if the necessary precautions are done. Be sure to ask the doctor first for other possible treatments and how the surgery will proceed so that the operation can go smoothly.
There are different types of hemorrhoid surgery. The first is called hemorrhoidectomy, where the hemorrhoid is removed by knife. Another is hemorrhoid laser surgery where the hemorrhoidal tissue is vaporized. This is one of the more popular treatments for hemorrhoids. The third one is Harmonic scalpel surgery for hemorrhoids that uses ultrasound that cauterizes the incision.
The patient and doctor will come to an agreement to which of the following types of surgery will be used and before undergoing the surgery, the patient must know what to expect.
During the surgery, you will be given anesthetics that will make you sleep for the entire duration of the operation. The hemorrhoids will be removed through the type of surgery that the patient and the doctor have decided on. The incisions will be closed or may be left open to heal naturally and the rectum is usually packed with gauze.
Recovery From Hemorrhoid Surgery
Recovery after the surgery varies from one person to another. It is natural to feel pain after a few days and your doctor will prescribe you medications to lessen the pain. You will also be recommended to take stool softeners to lessen the pain and bleeding, which is normal after the surgery. But if the pain gets worse, no bowel movement after 3-5 days, uncontrollable bleeding, and a fever, contact your doctor.
The main concern of the surgery does not focus only during the surgery but also after the surgery. Several complications may arise but it is difficult to know, so when in doubt, ask your doctors. Below are some of the complications that may arise after the surgery.
Early Complications Include:
- Severe postoperative pain, lasting 2-3 weeks. This is mainly due to incisions of the anus, and ligation of the vascular pedicles.
- Wound infections are uncommon after hemorrhoid surgery. Abscess occurs in less than 1% of cases. Severe necrotizing infections are rare.
- Postoperative bleeding.
- Swelling of the skin bridges.
- Major short-term incontinence.
- Difficulty urinating. Possibly secondary to occult urinary retention. Urinary tract infection develops in approximately 5% of patients after anal rectal surgery.
- Limiting postoperative fluids may reduce the need for catheterization (from 15 to less than 4 percent in one study).
Late Complications Include:
- Anal stenosis.
- Formation of skin tags.
- Anal fissure.
- Minor incontinence.
- Fecal impaction after a hemorrhoidectomy is associated with postoperative pain and narcotic use. Most surgeons recommend stimulant laxatives, or stool softeners to prevent this problem. Removal of the impaction under anesthesia may be required.
- Delayed hemorrhage, probably due to sloughing of the vascular pedicle, develops in 1 to 2 percent of patients. It usually occurs 7 to 16 days post surgery. No specific treatment is effective for preventing this complication, which usually requires a return to the operating room for one or more stitches.
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