GENERAL INFORMATION
Haemorrhoids are congested, swollen veins that are called internal haemorrhoids when they are just inside the anus. They are called external haemorrhoids when they are at the anal opening. There are many causes of haemorrhoids, including the following: chronic constipation, a job that requires a lot of sitting, pregnancy, liver disease, loss of muscle strength in the anal area with advancing age and obesity.
COMMON SIGNS AND SYMPTOMS
There can be a number of symptoms, sometimes more than one at the same time.
- Protrusion of the haemorrhoids on the outside.
- Pain or itching in and around the anus
- Blood in the stool.
- External haemorrhoids that are clotted and very painful.
DIAGNOSIS
• Usually the diagnosis can be made by taking a detailed history and doing a thorough physical examination.
• A painful, clotted haemorrhoid on the outside of the anus is easy to see.
• Anoscopy: This examination is done with a hollow instrument as long and as thick as your finger. It is lubricated and inserted into the anus gently so that the entire area can be inspected.
PRE-OPERATIVE PREPARATION
- Do not eat or drink anything for 6 hours before the operation.
- Your doctor will explain to you whether he wants you to have any laxatives or enemas before admission to hospital. He may prefer to have these given to you after you have been admitted.
- Make sure your doctor knows what medicines you take, especially medicines which may affect blood clotting
OPERATION
- The operation generally lasts between half an hour and one hour and will require a general anaesthetic.
- A sigmoidoscopy or colonoscopy is generally done with a haemorrhoid operation. This is done to examine the lower part of the large intestine above the level of the anal canal. Your doctor will discuss this with you.
POST OPERATIVE CARE
- Your doctor will discuss with you how long you need to stay in hospital.
- At times the pain may be significant but your doctor will discuss with you how to manage this.
- In addition to the pain there is always some post-operative bleeding. This is normal.
COMPLICATIONS
- Complications are not common after a haemorrhoidectomy, but you must be aware of the following possible complications.
- Occasionally a post operative bleed will occur. Your doctor will decide whether you need to be taken back to the operating theatre to manage this bleeding.
- A stricture or narrowing of the anus may develop occasionally after healing has taken place – this is extremely rare.
- A temporary leak of flatus or faeces from the anus frequently persists for a few days after the operation. In very rare instances this problem may persist for a long time or even permanently.
- It is possible for further haemorrhoids to develop after a haemorrhoid operation.
- Systemic complications like deep vein thrombosis and pulmonary embolism are rare but possible after any operation or anaesthetic.