digestive disorders center

Is Hemorrhoid Surgery (Hemorrhoidectomy) Painful?

Hemorrhoids are a common painful condition that involves swollen veins in the anal region. Hemorrhoid surgery (hemorrhoidectomy), which isn't a painful procedure, is the surgical removal of excess hemorrhoidal tissues that is performed on hemorrhoids that are large, extensive, or severe.
Hemorrhoids are a common painful condition that involves swollen veins in the anal region. Hemorrhoid surgery (hemorrhoidectomy), which isn't a painful procedure, is the surgical removal of excess hemorrhoidal tissues that is performed on hemorrhoids that are large, extensive, or severe.

Hemorrhoids are swollen veins in the anal region. Hemorrhoids are a common, painful and uncomfortable condition that can affect anyone. 

A hemorrhoidectomy is surgical removal of excess hemorrhoidal tissues that is performed on hemorrhoids that are large, extensive, or severe. 

Hemorrhoid surgery (hemorrhoidectomy) is performed under general anesthesia or spinal anesthesia so the procedure itself does not cause pain. Patients are also usually given a long-acting local anesthetic right before they wake up to provide up to 12 hours of pain relief following the surgery. 

However, once the anesthetic wears off, the recovery from hemorrhoid surgery can be painful for 2 to 4 weeks. Some bleeding is normal. To manage post-operative pain: 

  • Patients may be prescribed pain medication 
  • Application of topical numbing medicines may be recommended before and after bowel movements to manage pain
  • Apply ice packs to the anal area to help reduce swelling and relieve pain
  • Soaking in warm water (sitz baths) can help relieve pain and muscle spasms
  • Use of stool softeners that contain fiber may be advised to help reduce straining during bowel movements 
  • Patients are advised to consume plenty of liquids and eat a bland diet such as the BRAT diet (bananas, rice, applesauce, toast) 
  • Antibiotics may be prescribed to prevent infection

What Are Symptoms of Hemorrhoids?

Symptoms of hemorrhoids include: 

  • Rectal bleeding
    • Bright red
    • Usually only a small amount
    • Painless 
    • Often noticed after bowel movements
    • Blood is visible on toilet paper after wiping following a bowel movement
  • Anal itching or burning sensation 
  • Tissue bulging from the anal area
    • May appear dark blue to purple in color if there is a blood clot
  • Difficulty cleaning after a bowel movement
  • Pain and pressure in the rectal area
  • Feeling the need to have a bowel movement
  • Fecal leaking 

What Causes Hemorrhoids?

Hemorrhoids may be caused by: 

  • Straining during bowel movements
  • Chronic constipation or diarrhea
  • Inadequate fiber intake
  • Prolonged sitting (especially sitting on the toilet)
  • Lifting heavy objects frequently
  • Pregnancy
  • Weakening of the supporting tissues in the anus and rectum that occurs with aging
  • Tumors

How Are Hemorrhoids Diagnosed?

Hemorrhoids are diagnosed with a patient history and a physical examination of the rectum and anus, which may involve a digital rectal exam in which a medical professional inserts a gloved finger into the rectum. External hemorrhoids are visible on examination. 

Other tests to diagnose hemorrhoids include: 

  • Anoscopy to examine the anus
  • Rigid proctosigmoidoscopy to examine the lining of the rectum and lower colon
  • Sigmoidoscopy or colonoscopy to examine the colon

What Is the Treatment for Hemorrhoids?

Mild hemorrhoids may go away on their own in a few days. 

Home treatments for hemorrhoids include: 

  • Warm sitz baths 
    • Available in drugstores
    • Soak the buttocks in 2 or 3 inches of warm water for 10 to 15 minutes two to three times daily
    • Do not use soap, bubble bath, or other additives in the water
  • Increase fiber intake 
  • Drink plenty of water
  • Topical treatments 
    • Over-the-counter (OTC) pain-relieving creams and hydrocortisone rectal suppositories may help temporarily relieve pain, inflammation, and itching
    • Do not use topical treatments for more than one week unless recommended by a doctor
  • Laxatives
    • Use if increased fiber intake does not relieve constipation
  • Over-the-counter (OTC) pain relievers 
  • Don’t sit on the toilet for long periods 
  • Don’t strain during bowel movements

Medical treatments for hemorrhoids include: 

  • Rubber band ligation
  • Laser, infrared, or bipolar coagulation 
  • Sclerotherapy 
  • Surgery
    • Hemorrhoidectomy (surgical removal of excess hemorrhoidal tissues)
    • Stapled hemorrhoidopexy 
    • Hemorrhoidal arterial ligation

What Are Complications of Hemorrhoids?

Complications of hemorrhoids are uncommon and may include: 

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References
https://www.uptodate.com/contents/hemorrhoids-beyond-the-basics?search=Hemorrhoids&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/definition-facts

https://www.uofmhealth.org/health-library/hw212391