Most haemorrhoid related symptoms can be treated without surgery, with many patients benefiting from attention being paid to their diet and toilet or defecatory habits. The most common procedures for haemorrhoids if required are rubber band ligation or injection sclerotherapy.
When external haemorrhoids are large and/or when internal haemorrhoids are large and prolapse and cannot be reduced, or repeated minor procedures have failed to improve symptoms, excision of haemorrhoidal tissue known as a haemorrhoidectomy may be required, usually under a general anaesthetic.
If performed in conjunction with a colonoscopy you will have a full bowel preparation before surgery, and if performed alone you may have an enema prior to surgery.
The type of haemorrhoidectomy you will have depends on the size and arrangement of the haemorrhoids in your perianal region. Haemorrhoidectomy can be accompanied by significant discomfort, especially when you open your bowels. Local nerve blocks will control this initially post-op but most patients require pain relief in the first post-op days. The pain can last for one to two weeks following haemorrhoidectomy. You will be given specific instructions following the surgery about caring for your wound(s) but they usually include regular warm salt or sitz baths, avoiding hard wiping of the area, the use of perianal pads, taking of stool softeners, pain medicine, fibre supplements and possibly a laxative.
It may take up to 4-6 weeks for your wounds to heal after haemorrhoid surgery but most patients are back at work and other normal activities during that time.