Haemorrhoidectomy

Haemorrhoids, also known as piles, are swellings containing enlarged blood vessels found inside or around the bottom (the rectum and anus).

The exact cause of haemorrhoids is unclear.  It occurs due to increased pressure in the blood vessels in and around your anus. Chronic (long-term) diarrhoea can also make you more vulnerable to getting haemorrhoids.

Other factors that might increase your risk of developing haemorrhoids include:

  • being overweight or obese
  • old age
  • being pregnant – this can place increased pressure on your pelvic blood vessels, causing them to enlarge; read more about piles in pregnancy
  • having a family history of haemorrhoids
  • regularly lifting heavy objects
  • a persistent cough or repeated vomiting
  • sitting down for long periods of time

In many cases, haemorrhoids don't cause symptoms and some people don't even realise they have them.

However, when symptoms do occur, they may include:

  • bleeding after passing a stool – the blood is usually bright red
  • itchy bottom
  • a lump hanging down outside of the anus, which may need to be pushed back in after passing a stool
  • a mucus discharge after passing a stool
  • soreness, redness and swelling around your anus

Haemorrhoids aren't usually painful, unless their blood supply slows down or is interrupted. Haemorrhoidectomy is an operation to remove haemorrhoids. It is carried out under general anaesthesia.

Making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended.

 Gradually increasing the amount of fibre in your diet – good sources of fibre include fruit, vegetables, wholegrain rice, whole wheat pasta and bread, pulses and beans, seeds, nuts and oats

drinking plenty of fluid – particularly water, but avoiding or cutting down on caffeine and alcohol

  • not delaying going to the toilet – ignoring the urge to empty your bowels can make your stools harder and drier, which can lead to straining when you do go to the toilet
  • avoiding medication that causes constipation – such as painkillers that contain codeine
  • losing weight if you're overweight
  • exercising regularly – this can help prevent constipation, reduce blood pressure, and help you lose weight

There are various treatment options for more severe haemorrhoids. One of these options is banding, a non-surgical procedure where a very tight elastic band is put around the base of the haemorrhoid to cut off its blood supply. The haemorrhoid should fall off after about a week.

Some complications include:

  • bleeding or passing blood clots, which may happen a week or so after the operation
  • infection, which may lead to a build-up of pus– you may be given a short course of antibiotics after surgery to reduce this risk
  • difficulty emptying your bladder
  • the involuntary passing of stools
  •  a small channel that develops between the anal canal and surface of the skin, near the anus
  • Narrowing of the anal canal – this risk is highest if you have treatment on haemorrhoids that have developed in a ring around the lining of the anal canal.

Some other procedures involved:

1) Haemorrhoidal artery ligation is an operation to reduce the blood flow to your haemorrhoids. It's usually carried out under general anaesthetic and involves inserting a small ultrasound probe into the anus. The probe produces high-frequency sound waves that allow the surgeon to locate the vessels supplying blood to the haemorrhoid. Each blood vessel is stitched closed to block the blood supply to the haemorrhoid, which causes it to shrink over the following days and weeks. The stitches can also be used to reduce haemorrhoids that hang down from the anus.

2) Stapling, also known as stapled haemorrhoidopexy, is an alternative to a conventional haemorrhoidectomy. It's sometimes used to treat prolapsed haemorrhoids and is carried out under general anaesthetic. During the operation, part of the anorectal – the last section of the large intestine – is stapled. This means the haemorrhoids are less likely to prolapse. It also reduces the supply of blood to the haemorrhoids, which causes them to gradually shrink.

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