Most cases of hemorrhoids can be managed through the proper diet, easing bowel movements and treating symptoms with over-the-counter ointments. Some cases, though, cause more severe symptoms and must be dealt with in a more invasive manner.
There are a number of different procedures that are used to manage hemorrhoids. Some can be done in the doctor’s office and require little or no aftercare. In general, these are used to treat minor cases. They include:
- Banding
- Sclerotherapy
- Coagulation Therapy
In most cases that require surgical intervention, however, a hemorrhoidectomy is necessary. This procedure will take place in a surgical center or hospital, and anesthesia will be used. Some doctors prefer general anesthesia, or intravenous sedation, Others use regional or local anesthesia in conjunction with a sedative that allows you to relax during the procedure.
During this surgery, your doctor will remove the hemorrhoids by cutting them out. Afterward, you will be taken to an observation unit while you awaken and your vital signs are stabilized. Then you’ll be sent home to recover.
How Will I Manage The Pain?
Most people report that they feel better with each passing day after a hemorrhoid removal procedure. While this is good news, you should expect to have some pain for at least two weeks and maybe as long as four weeks. Depending on your own needs and what your doctor prefers, you may be prescribed a different pain management plan.
Some doctors offer prescription pain medicine for most patients following surgery. It is important to follow all of the dosing instructions carefully, and take these medications exactly as prescribed. If your doctor prefers not to give you a prescription for pain management, ask about over-the-counter pain relief. For many patients, Advil, Tylenol, Aleve or another medication is enough to manage the pain after surgery.
Even after the initial pain fades, many people have pain during or after bowel movements for a month to six weeks after surgery. Applying hemorrhoid cream, like over-the-counter hydrocortisone, may help numb this pain, and relieve any itching. Some doctors prefer that patients use non-medicated treatment for this pain, though, so be sure to ask your doctor.
What Do I Need To Know About Aftercare?
In addition to pain medication, many people find that taking regular sitz baths helps to relieve the pain associated with hemorrhoid surgery. This consists of sitting in a few inches of water for up to half an hour three or four times a day. The warm water will help to clean the anal area, as well as relax the muscles to ease pain. You can continue this routine for as long as you experience post-surgical pain.
One of the keys to quick healing is to avoid straining while having a bowel movement. If you’re not eating well due to pain or fatigue after surgery, or if constipation was responsible for your hemorrhoids in the first place, this may require eating more fiber than you are accustomed to. You should also drink water throughout the day. If you are still struggling with regularity, your doctor may suggest a laxative, stool softener or fiber supplement.
After a bowel movement, you may have light bleeding. This typically lasts around a month after surgery, but could continue for as long as eight weeks until the incision fully heals. You can lessen this by using wet wipes instead of toilet paper during this time. Ask your doctor what is recommended, because some prefer baby wipes while other doctors recommend medicated pads. Do not clean your anal area with soap, as this can be extremely irritating.
As with any surgery, there is a risk of infection after hemorrhoid removal. It is important to call your doctor if you have swelling, redness or increased pain, a fever or any unusual draining from the site. Infection after hemorrhoidectomy is extremely rare.
When Can I Return To Work?
Most people only miss a week to ten days of work after hemorrhoid surgery, and can return to their normal routine within two weeks. Of course, this may vary depending on your job and how active you are in your free time. Until your body has fully healed, you should avoid heavy lifting or exercising after hemorrhoid surgery. This may take four to six weeks.
After surgery, your doctor will probably schedule at least one follow up appointment to check your progress. If you’re feeling better, you may be tempted to skip this appointment and return to your usual activities. This appointment, and your doctor ensuring you are healed enough to return to work, is vital and should not be skipped.
Even once you’ve been released to go to work, it is important to rest any time you feel tired. However, staying active can help the healing process. If you have a desk job, you may want to consider taking regular walks around the office to reduce pressure and increase blood flow to your anal area.
Can I Stop My Hemorrhoids From Coming Back?
While you will probably feel back to normal in about 14 days after your hemorrhoidectomy, it’s probably not a procedure you’ll want to repeat. However, there is always the risk of a recurrence of hemorrhoids. This is especially true if you continue to follow the same dietary and bathroom habits that you were before surgery. In order to reduce your chances of a recurrence, your doctor will probably recommend eating a high fiber diet, staying hydrated and exercising regularly. You may also be able to reduce your risk by losing weight, especially if you are carrying a lot of extra pounds. Sometimes, recurrences are unavoidable. But it is important that you do your part in the healing period to try to lessen this risk.