What are the types of piles surgery?
Our Dr will advise you on the pros and cons of each treatment method, and individualise your surgery after assessing your piles and your symptoms.
What is a thrombosed pile?
In thrombosis, the pile is swollen and painful due to a blood clot within .The main symptoms usually pain and prolapse. If a patient presents soon after the thrombosis or is in severe pain, the blood clot can be removed in the clinic through a small cut. The release of the clot provides immediate relief. If the patient presents when the thrombosis is several days old, it may be partially resorbed by the body (just like any clot/bruise under the skin) already and treatment is usually with medications to treat the symptoms present. Surgery would not be needed then. In certain cases, the thrombosis may get infected or show signs to suggest infection. If that is so, surgery is recommended to prevent any secondary infections of the anus.
What can I expect postoperatively?
Depending on the type of operation done, there can be some variations to your post-operative recovery. There is usually no dietary restriction after surgery. You will have some degree of loss of control to passage of flatus (gas). That will recover when the wounds heal.
After excisional haemorrhoidectomy, the wounds may take up to 4 weeks to heal. There is minimal pain at rest but having a bowel movement can be painful unless oral and topical medications are used. After stapled haemorrhoidectomy, there is a persistent urge (tenesmus) to pass motion as the staple line pain feels like having a need for bowel movement. This discomfort usually lasts about 7-10 days, but can be controlled with medications. For THD, there is no tissue cut, hence not as painful as haemorrhoidectomy.
Whichever technique is used for surgery, there is a small risk of bleeding which can happen 5-10 days after surgery. This is usually due an infection of the wound or staple line which may occur regardless of hygiene, wound care or antibiotics. This is because the rectum and anus is the dirtiest area of the body through which stools pass through. This bleeding can be easily stopped with an injection into the bleeding site and re-operation is very rarely needed. Most important is to inform us if you develop a fever or increased bleeding within the first 2 weeks after surgery.
Does surgery cure the piles?
As the aim of surgery is to return the anus to its normal function, there is always risk of recurrence of haemorrhoids. However, surgery will most certainly help improve your symptoms from the problematic piles. This is not a failure of surgery as all the vessels at the anus cannot be removed completely, otherwise, the patient will develop bowel incontinence. Each of the operations can be repeated if necessary without harm to the patient. Most important is to reduce the predisposing factors. In order to prevent recurrence after treatment of haemorrhoids, you should try to avoid excessive straining during bowel movement as well as bad toilet habits. To avoid straining, you should ensure you drink adequate amounts of fluids, have enough fiber and avoid constipation.
