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Haemorrhoidectomy

What is it?

Haemorrhoidectomy is a medical procedure that is performed to remove haemorrhoids. Haemorrhoids, also called piles, are small, round, fleshy bumps that contain enlarged blood vessels typically found around the anus or in the anal canal. They are associated with an increased pressure in the blood vessels in and around anus causing them to become inflamed and swollen.

When is it needed?

Some of the symptoms usually associated with Haemorrhoids are:

  • Painless bleeding during bowel movements
  • Itching or irritation in the anal region
  • Pain or discomfort
  • Swelling around the anus
  • Lump present near the anus that can be sensitive or painful

Causes

Some of the usual causes of haemorrhoids include,

  • Straining during bowel movements
  • Spending long periods of time sitting on the toilet
  • Chronic diarrhea or constipation
  • Obesity
  • Pregnancy
  • Anal intercourse
  • Low-fiber diet

Types of Haemorrhoids

Haemorrhoids can be of the following types:

  • Internal haemorrhoids: usually lie inside the rectum. Straining or irritation when passing stool can damage a haemorrhoid’s surface and cause it to bleed. Straining can push an internal haemorrhoid through the anal opening, which is known as a protruding or prolapsed haemorrhoid and can cause pain and irritation.
  • External haemorrhoids: are typically found under the skin around the anus. When irritated, these external haemorrhoids can itch or bleed.
  • Thrombosed haemorrhoids: Sometimes blood may pool in an external haemorrhoid and form a clot that can result in severe pain, swelling, inflammation and a hard lump near the anus.

Treatment

The removal of haemorrhoids is the most effective treatment for Haemorrhoids. This is usually performed either using Minimally Invasive Procedures or Open Surgical Procedures. The procedures under both these categories are explained below:

Minimally Invasive Procedures

  • Rubber band ligation
    The doctor places one or two tiny rubber bands around the base of an internal haemorrhoid to cut off its circulation. After a week or so, the haemorrhoid usually withers and falls off.
  • Sclerotherapy
    In this procedure, the doctor injects a chemical solution into the haemorrhoid tissue to shrink it. 
  • Coagulation
    This procedure usually employs techniques using laser, infrared light or heat. Coagulation can cause the small, bleeding internal haemorrhoids to harden and shrivel.

Open Surgical Procedures

  • Haemorrhoidectomy
    In this procedure, the surgeon removes the excessive tissue causing the bleeding. This is the most effective of all haemorrhoid removal techniques, especially for recurring or severe haemorrhoids. The doctor might prescribe medications to relieve the pain after the surgery. Patients are usually advised to soak in a warm bath too.
  • Haemorrhoid Stapling
    The last section of the large intestine is stapled to reduce the blood supply to the haemorrhoids so that they shrink, thus reducing the likelihood of prolapse. This is usually recommended for internal haemorrhoids.
  • Haemorrhoidal Artery Ligation
    The blood vessels supplying haemorrhoids are located and then each blood vessel is stitched closed to cut off the blood supply to haemorrhoids so that they shrink.

Risks

Some of the risk factors involved in the removal of haemorrhoids by surgery are:

  • Excessive bleeding
  • Difficulty urinating
  • Infection, which might cause a high temperature
  • Loss of control of the rectal sphincter
  • Narrowing or damage to the anal canal
  • Some patients might experience difficulty in emptying their bladder, resulting in urinary tract infections.

Post-Procedure

The doctors might suggest the following measure after the procedure:

  • Eat high-fiber foods
  • Use topical treatments
  • Soak the anal region 10 to 15 minutes two to three times a day in plain warm water.
  • Keep the anal area clean
  • Apply cold
  • Take oral pain relievers.