Hemorrhoids are swollen veins in the anus or rectum.

• External hemorrhoids develop just outside the anus.
• Internal hemorrhoids develop in the lower rectum, just above the anus.
• An internal hemorrhoid that comes out through the anal opening is called a prolapsed hemorrhoid.

Some people who have hemorrhoids have no symptoms. For others, symptoms may include:

• A painful swelling or lump in the anal area
• Irritation and itching in the anal area
• The feeling that bowel movements are incomplete
• Bright red blood on toilet paper or stool

If hemorrhoids are severe and untreated they can lead to:

• A blood clot in the vein
• Rectal ulcers
• Infection
• Severe pain
• The inability to control urination or bowel movements

When the blood supply to a hemorrhoid is affected it can cause death of tissue (gangrene). In this case the hemorrhoid needs to be surgically removed.

A hemorrhoidectomy is the surgical removal of hemorrhoids. It can be done with:

• A rubber band, which is placed around the base of the hemorrhoid to stop blood flow
• A scalpel, scissors, laser, or ultrasonic shears to remove the hemorrhoid
• An electrical current, which stops blood flow
• A combination of techniques

Hemorrhoids are caused by increased pressure within the veins in the rectal area. The increased pressure causes enlargement of the veins. Factors that may contribute to hemorrhoids include:

• Straining to have a bowel movement or lifting heavy objects
• Pregnancy and childbirth
• Heredity
• Aging and loss of muscle tone
• Chronic diarrhea or constipation
• Certain liver diseases
• Prolonged sitting
• Obesity
• Low-fiber diets
• Rectal surgery

Rectal bleeding is often related to hemorrhoids. However, it can also signify more serious conditions, such as colorectal cancer. Contact your healthcare provider if you have rectal bleeding or other symptoms that are persistent. He or she will take a medical history and perform a physical exam to find out whether your symptoms are due to hemorrhoids or another condition. To diagnose internal hemorrhoids, your healthcare provider may recommend:

• A digital rectal exam, where a gloved finger is inserted into the anus
• An anoscopy (an exam of the anus and lower rectum using an instrument inserted into the anus)
• a proctoscopy (using a small tube to see the internal part of the rectum)

A sigmoidoscopy or colonoscopy may also be recommended if you need a more complete exam of the colon to rule out a more serious condition.

Treatment options for hemorrhoids vary depending on the location and severity of the hemorrhoids. Most hemorrhoids can be treated with:

• Self-care treatments
• Over-the-counter medications
• Minor procedures performed in the office, such as band ligation

Your healthcare provider may recommend a hemorrhoidectomy if conservative treatments have not improved symptoms that affect your quality of life. Prior to surgery, tell your healthcare provider about any medications you are taking (including over-the-counter medications and supplements). Ask about specific instructions you should follow before surgery and get clear instructions on what you need to do. These may include:

• Medications you should not take before the surgery, such as blood thinners
• Regular medications you should continue to take on the day of your surgery
• How many hours you should stop eating and drinking before the surgery

If you are a smoker, you should quit smoking, as it can interfere with your recovery.

A hemorrhoidectomy is usually done in an operating room on an outpatient basis. The type of anesthesia you are given depends on your circumstances. You may receive:

• A local, which numbs only the area being operated on
• A spinal, which numbs you from the waist down
• General anesthesia, which puts you into a deep sleep so that you are unable to see, hear or feel anything

After surgery, expect some pain and tenderness at the site. Soaking in a warm bath can help. You may also be told to:

• Avoid heavy lifting
• Limit your activity for a few weeks
• Avoid straining during a bowel movement or urination
• Stool softeners are usually recommended

Complete recovery from a hemorrhoidectomy may take up to three to four weeks. Most people can resume normal daily activities in about a week.

• Pain medication and help at home may be needed while you recover.
• Don't forget to make arrangements for transportation to and from the facility.

If your healthcare provider recommends a hemorrhoidectomy, ask the following questions.

• What caused my hemorrhoids?
• What treatment options do you recommend? What are the risks to each treatment?
• Are than any alternatives to surgery? What are the pros and cons of each?
• Are there any risks if I decide not to have surgery?
• How likely is it that my hemorrhoids will recur?
• What has your experience been with patients you have operated on for hemorrhoids?
• How can I prevent future hemorrhoids?
• What are the possible complications to this surgery?
• How will I feel after the surgery? Will I have to modify my activity?
• After surgery, what symptoms should I be concerned about? What pr/ecautions do I need to take?

Prior to discharge, you should understand all home care instructions. This includes symptoms to report before your next appointment, medications and their side effects and follow-up plans. Don't forget to make arrangements for transportation to and from the facility and for help at home while you recover.

Source UHC.com

Also known as:

Removal of Hemorrhoids

Hernia

Hemorrhoids

Hemorrhoidectomy

Hemorrhoid Surgery