Hemorroids Surgery - Hemorrhoidectomy

Hemorroids surgery is the last line of defense against hemorroids. Most hemroids can be treated and cured with more conservative treatments, but others must be dealt with surgically. Hemorroids surgery comes in about a half dozen varieties: the hemroidectomy, hemroid banding, laser coagulation, infrared photocoagulation, injection sclerotherapy and hemroid stapling.

Advanced Healing Methods

Surgical treatment may be recommended for hemorroids that become very advanced, protruding from the anus (prolapse), bleeding frequently, or containing blood clots (thrombosis). Common procedures include freezing the affected tissue (cryotherapy), injecting chemicals into the hemorroid to shrink it (sclerosing solutions), surgically removing the hemorroid (hemorrhoidectomy), or placing rubber bands around the hemorroid for removal (ligation).

Hemoroid Surgery Information

To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and lower colon (sigmoid) with sigmoidoscopy or the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum.

Diagnosis begins with a visual examination of the anus, followed by an internal examination during which the doctor carefully inserts a gloved and lubricated finger into the anus. The doctor may also use an anoscope, a small tube that allows him or her to see into the anal canal. Under some circumstances the doctor may wish to check for other problems by using a sigmoidoscope or colonoscope, a flexible instrument that allows inspection of the lower colon (in the case of the sigmoidoscope) or the entire colon (in the case of the colonoscope).

Operative therapy decreases sphincter pressure either by forceful dilation or by lateral internal sphincterotomy. Although this technique is an effective outpatient surgical procedure performed under local anesthesia, its fundamental drawback is its potential to cause minor alterations in the control of gas, mucus, and occasionally stool. This problem has motivated research for pharmacologic ways to create a reversible"sphincterotomy," one that would lower sphincter pressures while hemorroids are healing.

What to Expect at Your Provider's Office

Your provider will do an examination. If you have had significant bleeding or other symptoms, your provider may perform a procedure called sigmoidoscopy, or colonoscopy. In this procedure a small instrument is inserted into the rectum for inspection of tissues to check for other diseases.

Nonsurgical Hemorroids Treatments

Treatment of hemorroids depends on when a patient sees a doctor. The clot can be removed with an almost painless office procedure if the patient sees a doctor within a day or two of first feeling the discomfort. The procedure speeds the recovery time. If the patient waits three or more days, medical treatment will resolve the discomfort, but relief may take up to a week.

With rubber-band ligation a tight rubber band is placed around the hemorroid inside the rectum. The band cuts off circulation and the hemorroid withers away within days. Sclerotherapy uses chemical solution injected around the blood vessel to shrink the hemorroid.

Heal Faster with Alternative Banding

Rubber band ligation is probably the most widely used of the many treatments for internal hemorroids (and the least costly for the patient). This procedure is performed in the office of a family doctor or specialist, or in a hospital on an outpatient basis and heals faster. An applicator is used to place one or two small rubber bands around the hemorroid, cutting off its blood supply. After 3 to 10 days the bands, the hemorroid falls off, leaving a sore that heals in a week or two. Because internal hemorroids are located in a part of the anus that does not sense pain, anesthetic is unnecessary and the procedure is painless in most cases. Although there can be minor discomfort and bleeding for a few days after the bands are applied, complications are rare and most people are soon able to return to work and other activities. If more than one hemorroid exists or if banding is not entirely effective the first time (as occasionally happens), the procedure may need to be repeated a few weeks later. After five years, 15–20% of patients experience a recurrence of internal hemorroids, but in most cases all that is needed is another banding.