Surgery to remove hemorrhoids and end the pain

To remove internal or external hemorrhoids, it may be necessary to have surgery, which is indicated for patients who, even after undergoing treatment with medication and adequate diet, maintain pain, discomfort, itching and bleeding, especially when evacuating.

There are several techniques to remove hemorrhoids, the most common being hemorrhoidectomy, which is the traditional technique that is done through a cut. The recovery takes between 1 week to 1 month, being necessary to stay in the hospital for about 2 days and maintain good hygiene of the intimate region during the recovery time.

Surgical techniques to remove hemorrhoids

Some techniques for removing internal or external hemorrhoids can be:

1. Hemorrhoidectomy

Hemorrhoidectomy is the most common surgery and involves removing hemorrhoids through a cut and is common in external or internal hemorrhoids of grades 3 and 4.

2. Technique by THD

This technique, known as transanal hemorrhoidal materialization, is done without cuts and consists of suturing the blood vessels that supply blood to the hemorrhoid, being common in grades 2, 3 and 4. See how this surgery is done.

3. PPH technique

The PPH technique is known as staple hemorrhoidopexy, which is a way to remove hemorrhoids through a ring that tightens the hemorrhoid and leads to cell death, being a procedure that does not need sutures, is less painful and is done on internal hemorrhoids grades 3 and 4, with little volume;

4. Lacquering with elastic

This is a treatment where a small elastic band is applied at the base of the hemorrhoid, which will interrupt the blood transport and cause its death, being common in the treatment of hemorrhoids of grades 2 and 3;

5. Sclerotherapy

In this technique, a product that causes tissue death is injected into the hemorrhoid vessels, being used for the treatment of grade 1 and 2 hemorrhoids. Learn more about this procedure.

In addition, there are also other methods that can be used to remove hemorrhoids, such as infrared coagulation, cryotherapy and laser, for example, and the choice of technique will depend on the type and degree of hemorrhoid that you want to treat.

6. Infrared coagulation

This is a technique that can be used to treat internal bleeding in hemorrhoids. For this, the doctor uses a device with an infrared light that heats the place and creates a scar on the hemorrhoid, making the blood stop passing and, consequently, the hemorrhoid tissues harden and end up falling.

Infrared coagulation usually has very few side effects and causes very little discomfort.

Classification of the degree of internal hemorrhoids

Internal hemorrhoids are those that develop and remain inside the anus, and can present different degrees, such as:

• Grade 1 - Hemorrhoid that is found inside the anus, with a slight enlargement of the veins; Grade 2 - Hemorrhoid that leaves the anus during defecation and returns to the interior spontaneously; Grade 3 - Hemorrhoid that leaves the anus during defecation and that needs to be re-introduced into the anus with the hand; Grade 4 - Hemorrhoid that develops inside the anus but that due to its enlargement it comes out through the anus, which can cause rectal prolapse, which is the exit of the final part of the intestine through the anus.

External hemorrhoids are those that are on the outside of the anus, and these can also be removed through surgery, because they cause discomfort especially when sitting and defecating.

How is the surgery done

In most cases, surgery to remove hemorrhoids is performed under general anesthesia and requires the patient to be hospitalized for about 2 days.

To remove hemorrhoids, the proctologist must choose the most appropriate technique for each case, because they vary depending on the type of hemorrhoid the patient has.

How is the postoperative

Although the surgery does not cause pain, in the postoperative period it is normal for the patient to experience pain in the perineal region, especially when sitting and on his first evacuation after surgery, as this region is more sensitive. In this way, the doctor usually indicates:

• Use of analgesics to control pain and discomfort, such as paracetamol every 8 hours; Use of laxatives to make stools softer and easier to evacuate; Performing a cold water bath for 20 minutes, the number of times necessary to reduce discomfort; avoid using toilet paper, washing the anal area after evacuation with warm water and mild soap; using an ointment guided by the doctor, twice a day, to help heal the region.

After surgery, it is recommended to use a round buoy-shaped pillow to sit, in order to decrease the risk of bleeding and reduce pain. In addition, during the first month after surgery, foods rich in fiber and drinking plenty of water should be preferred, so that stools are softer and easier to evacuate.

Normally, the patient does not need to remove the stitches and, after total healing, there are no scars.

Check out in the following video how food should be to facilitate intestinal transit and prevent hemorrhoids:

What is the recovery time

The recovery from hemorrhoid surgery depends on the type and degree of hemorrhoid and the surgical technique performed, and can vary between 1 week and 1 month, so that the patient can normally resume their day-to-day activities.

It is normal that during the first week after surgery, the patient has small blood losses through the anal area, however, if this bleeding is severe it is recommended to go to the hospital to check if he is recovering correctly.