A hemorrhoidectomy is a surgical procedure to remove hemorrhoids. Most people won’t need surgery for hemorrhoids, but if they keep coming back or cause serious complications, a hemorrhoidectomy can end them once and for all. The procedure is simple, but the recovery can be a bit rough. Follow our advice to minimize pain and prevent constipation.
A hemorrhoidectomy is a surgical procedure to remove hemorrhoids. Hemorrhoids are enlarged blood vessels in your anus (butthole) that can sometimes cause uncomfortable symptoms, like anal pain and bleeding.
Hemorrhoids are common, and usually harmless. Most won’t require any medical treatment, let alone surgery. But in certain circumstances, for certain hemorrhoids, hemorrhoidectomy is the best option.
Hemorrhoidectomy is uncommon. Only about 5% of people develop symptoms with hemorrhoids. Of these, only 30% seek medical treatment. Of those who seek treatment, only 10% will need hemorrhoidectomy surgery.
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Your healthcare provider might recommend hemorrhoidectomy surgery if your hemorrhoids are more complicated than average. Complications that might require a hemorrhoidectomy include:
The operation itself isn’t very long or complicated, but the recovery period can be. This varies from person to person. Recovery can be difficult, and it can take between two and eight weeks.
Your recovery time will depend on how much pain and how many other complications you have. Pain and slow healing are common complaints, but they seem to be declining as surgical techniques evolve.
Your surgeon will discuss the risks and benefits of the procedure and obtain your informed consent. They’ll also discuss your current medications and which ones to stop taking before your surgery.
They’ll ask you to stop eating and drinking within eight hours before the procedure. Your anal canal will need to be clear, so if you have constipation, they might give you an enema before the procedure.
You’ll be under anesthesia for the procedure, so you won’t feel or notice what’s happening. Your surgeon will locate your hemorrhoids, cut out (excise) the affected tissue and seal the blood vessels.
They may close the wounds by bringing the edges back together (closed hemorrhoidectomy) or leave them open (open hemorrhoidectomy), depending on where they’re located and how wide they are.
Surgeons have different methods of excising and resealing the tissue and blood vessels. The traditional way is to cut with a scalpel, seal the blood vessels and close the wound with dissolvable stitches.
More recently, surgeons have begun using an electrothermal device to both cut and seal the tissues and blood vessels. The electrothermal energy promotes healing of the tissues, leading to faster recovery.
You’ll be able to go home the day of surgery, though you’ll need someone else to drive you. It’ll take a few hours for the anesthesia to wear off completely. As it wears off, you’ll start to feel pain.
You may take over-the-counter (OTC) painkillers, or you may have prescription painkillers to take home with you. You’ll also have detailed instructions for taking care of yourself during your recovery.
The primary advantage is that it works. Hemorrhoids removed in surgery generally don’t return. While it has a longer recovery time than other treatments, surgery should bring you permanent relief in the end.
A hemorrhoidectomy is also an important option in an emergency. If you have a thrombosed hemorrhoid or a strangulated hemorrhoid, surgery can treat it urgently and prevent worse outcomes.
Short-term risks of surgery include:
Possible complications during your recovery include:
Possible long-term complications that can develop include:
With careful technique, serious complications are rare.
Your healthcare provider might not recommend hemorrhoidectomy for you if you have certain medical conditions that could increase your risk of serious complications from the procedure. These include:
The average recovery time is two to four weeks. Most people say the pain is gone after two weeks. It might be six to eight weeks before you’re able to resume strenuous exercise or manual labor.
You might have a longer recovery if you have complications, like infection or excessive bleeding. Your healthcare provider will instruct you on caring for your wound to help prevent these complications.
After hemorrhoidectomy surgery, you can expect some degree of:
Healthcare providers assess post-hemorrhoidectomy pain using a visual analog scale (VAS). It rates pain on a scale of one to 10, with 10 being the worst. Pain ratings range from moderate to severe.
Pain is very subjective, and people can experience it differently. There’s not always an apparent reason for this. However, you may be more likely to experience more pain if you have:
Typically, the most significant pain occurs with your first bowel movement after hemorrhoidectomy surgery. Pain usually improves after three days and continues to improve for the next two weeks.
Healthcare providers continue to explore new strategies for reducing post-hemorrhoidectomy pain. Some research suggests that people experience less post-hemorrhoidectomy pain with:
In addition to the care you receive from your healthcare provider, you can also improve your pain levels and healing time by taking good care of yourself at home. Your provider will advise you on self-care.
Pooping can be painful after a hemorrhoidectomy, especially the first time. It gets easier as you heal. You can improve your pain levels and your healing time by preventing constipation and straining.
For some people, this is a chronic problem that likely contributed to getting hemorrhoids in the first place. For others, it’s a problem that can develop after surgery and with the use of pain medications.
Healthcare providers suggest that you:
Healing from a hemorrhoidectomy takes time, but you can help the process along by taking good care of your wound and your body during your recovery. For aftercare, healthcare providers recommend:
Schedule a follow-up appointment with your provider a few weeks after your hemorrhoidectomy. They’ll check to make sure you’re healing well. Call them sooner if you have any unusual symptoms, like:
A note from Cleveland Clinic
Hemorrhoidectomy surgery has a bit of a reputation for being rough, which might make it daunting to consider. But if you’re ready to be done with your hemorrhoids once and for all, it’s worth considering.
The hemorrhoidectomy experience has been gradually improving as surgeons adopt new tricks and techniques to make your recovery more comfortable. Its reputation isn’t necessarily up to date.
Nevertheless, it’s likely to be a little rough some of the time. Knowing what to expect and preparing ahead of time for your recovery can help to make this period pass as smoothly as possible.
Keep in mind that recovery is temporary, while hemorrhoid pain and irritations can be ongoing. Most people say they don’t regret having hemorrhoidectomy surgery and that the relief at the end is worth it.
Last reviewed by a Cleveland Clinic medical professional on 10/11/2023.
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