Hemorrhoids occur when the blood vessels in the outer part of the anus swell. Typically, these vessels swell due to straining during a bowel movement, from pregnancy and hormonal changes, or from trauma to the area. In some people, hemorrhoids become so problematic that they must be removed in a procedure called a hemorrhoidectomy. Generally, a doctor opts to perform a hemorrhoidectomy when the hemorrhoids are extremely large, when the patient has both internal and external hemorrhoids, or when the patient has difficulty staying sanitary because of the hemorrhoids.
During a hemorrhoidectomy, the patient is given a local anesthetic that lasts about twelve hours. This also helps prevent the patient from feeling pain after the hemorrhoidectomy is complete. During the surgery, the swollen vessel is cut with a scalpel. The surgeon then ties off both ends of the hemorrhoid in order to prevent bleeding while the hemorrhoid is removed.
After the hemorrhoid is removed, the incision is sewn or cauterized shut. Medicated gauze is then placed over the remaining wound. Typically, patients are sent home the same day, provided they are capable of urinating following the surgery. The ability to urinate is a concern because swelling after the surgery can block the urinary tract.
Healing time following a hemorrhoidectomy is generally two to three weeks. During this time, the patient must eat a high fiber diet and drink plenty of fluids in order to keep the stool soft. Some bleeding may also occur following surgery. Therefore, blood in the stool is considered normal.
Pain is a very common issue after a hemorrhoidectomy. Hemorrhoidectomy patients should alternate warm sitz baths with ice packs to reduce swelling, inflammation, and pain. Antibiotics are also often prescribed as a precautionary measure against infection.
There are few risks following a hemorrhoidectomy. Typically, the harshest side effect is pain and some difficulty with urination. In rare cases, the anal passage narrows after a hemorrhoidectomy and makes it more difficult to pass stool. In this case, stool can become trapped in the anal cavity and create an infection. Bleeding can also occur from the incision site. If these issues occur, the patient should contact his or her doctor.