Haemorrhoids

Haemorrhoids, also known as piles, are swollen veins in the lower rectum or around the anus. They may be internal or external.

Symptoms may include bleeding during bowel movements, pain, itching, swelling, discomfort, or a lump at the anus. Haemorrhoids may worsen with constipation, straining, pregnancy, prolonged sitting, or chronic diarrhoea

What to expect

Before Your Surgery

  • Authorization should be obtained prior to surgery and will be done by the hospital or the rooms staff depending on whether you are an in- or outpatient.
  • Make sure that you have been fasting for solid foods for at least 6 hours prior to your surgery and for clear liquids or water for at least 2 hours prior to your surgery. Discuss your chronic medications with your doctor or hospital staff prior to your surgery as you usually are allowed to take chronic medications the day of surgery, barring diabetic medication the day of the procedure. If you are taking any blood thinning medication please discuss these in detail with your doctor as special arrangements need to be made for these.

Day of Surgery

You will be admitted to hospital or day theatre. The procedure is usually performed under general or spinal anaesthesia. After surgery, you will be monitored in recovery before discharge or transfer to the ward.

Procedure

Treatment depends on the severity of the haemorrhoids. Mild cases may be treated with dietary changes, stool softeners, topical medication, and avoidance of straining.

Surgical or procedural treatment may include rubber band ligation, haemorrhoidectomy, or stapled haemorrhoidopexy. During haemorrhoidectomy, the enlarged haemorrhoidal tissue is removed. The wound may be left open or closed with sutures depending on the case.

Procedure Length

The procedure usually takes 30–60 minutes, depending on the type and extent of treatment required

Possible Complications

  • Possible complications include bleeding, infection, pain, swelling, urinary retention, constipation, recurrence, anal narrowing, delayed wound healing, and unintended damage to surrounding structures.

Duration of Hospital Stay

Most patients are discharged on the same day or after an overnight stay, depending on the procedure and pain control.

Discharge Instructions

  • Take prescribed pain medication, stool softeners, and antibiotics if provided. Avoid constipation and straining. Drink plenty of water and maintain a high-fibre diet.
  • Warm sitz baths may help with pain and hygiene. Mild bleeding or discharge can occur initially, but heavy bleeding, fever, severe pain, or difficulty passing urine should be reported.

Return to Activities

  • Light walking is encouraged. Avoid heavy lifting, prolonged sitting, cycling, and strenuous exercise for 1–2 weeks or until comfortable.

Back to Work Estimation

  • Desk work: approximately 5–7 days.
    Physically demanding work: approximately 2–3 weeks, depending on pain and healing.

Follow-Up and Results Discussion

A follow-up appointment may be arranged 5–7 days after surgery for wound review if necessary.

A further follow-up is usually arranged 10–14 days after surgery for wound assessment, suture removal if applicable, and histology discussion if tissue was sent for analysis.