When Do Piles Need Surgery? What To Expect Before and After

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When Do Piles Need Surgery? What To Expect Before and After

Piles, also known as hemorrhoids, are a common complaint affecting millions of people worldwide. Piles develop when the blood vessels in the anal canal swell and become inflamed, resulting in uncomfortable symptoms like pain, itching, and bleeding during bowel movements. While there are nonsurgical options available, there are situations where surgical intervention becomes necessary.

This article explores when piles need surgery and what patients can expect before and after the procedure.

When Is Surgery for Piles Necessary?

Most hemorrhoids can be treated with conservative management, such as lifestyle changes, topical medications, and nonsurgical procedures. However, surgical treatments may be required for severe or recurrent cases. For instance, patients experiencing persistent blood in their stool may need to consult a piles specialist Singapore residents recommend or other healthcare providers in your region to discuss surgical options.

Surgery is often recommended for Grade III or IV internal hemorrhoids. These are prolapsed hemorrhoids that can’t be pushed back into the anal canal or remain outside. Meanwhile, it can also be helpful for thrombosed external hemorrhoids, which happen when a painful blood clot forms in an external hemorrhoid.

For patients suffering from recurrent hemorrhoids, such as when symptoms return despite nonsurgical treatments, surgical methods may be the best option. The same goes for those experiencing excessive or persistent rectal bleeding and conditions like anal stenosis, anal stricture, or scar tissue formation.

Types of Hemorrhoid Surgery

Common types of hemorrhoid surgery include:

1. Traditional Hemorrhoidectomy (Excisional Hemorrhoidectomy)

This involves the surgical removal of hemorrhoidal tissue. It’s effective for severe cases but has a longer healing time and may cause postoperative pain.

2. Stapled Hemorrhoidopexy (Hemorrhoid Stapling)

Using a stapling device, prolapsed hemorrhoids are repositioned, restricting their blood supply. It’s less painful than traditional surgery but may have a higher risk of recurrence.

3. Doppler-Guided Hemorrhoidal Artery Ligation (DG-HAL)

This minimally invasive procedure uses ultrasound to locate and tie off the hemorrhoidal arteries, reducing blood flow to the hemorrhoids.

4. Laser Hemorrhoidectomy

This uses laser energy to remove hemorrhoidal tissue with minimal bleeding and pain.

5. Closed Hemorrhoidectomy

This technique involves removing hemorrhoids and suturing the wound, which may reduce bleeding and promote faster healing.

By understanding the various types of hemorrhoid surgery, along with their benefits and risks, you can work with your healthcare provider to make the best decision that leads to a positive health outcome for your condition.

What to Expect Before Surgery

Before undergoing surgery for piles, your healthcare provider will review your medical history, family history of hemorrhoids, and any underlying conditions like inflammatory bowel disease. You may also undergo diagnostic tests to assess the severity of your hemorrhoids.

Preparation for surgery may include eating more fibre and getting sufficiently hydrated to soften stools, as well as avoiding heavy lifting or strenuous physical activity. Patients should also stop certain medications, such as blood thinners, as advised by their doctor, and discuss anesthesia options, which may include a spinal block or local anesthesia, to ensure a safe and comfortable experience.

What to Expect After Surgery

Recovery after hemorrhoid surgery varies depending on the type of procedure performed. Here’s what you can expect:

1. Immediate Postoperative Period

Immediately after surgery, patients can expect mild to severe pain, which is common and can be managed with prescribed more potent medicines or over-the-counter pain relievers. Some rectal bleeding is normal, but excessive bleeding requires immediate medical attention.

Meanwhile, difficulty urinating, often due to a spinal block, is another common side effect. Sitz baths may help alleviate discomfort and promote healing in these cases.

2. Recovery and Healing

During the recovery and healing process, maintaining a high-fiber diet, taking fiber supplements, and drinking plenty of fluids is essential to prevent straining during bowel movements. Patients should also gradually resume regular activities and avoid strenuous tasks as their body heals. Meanwhile, follow-up care is crucial to monitor healing and address any concerns.

3. Potential Complications

While most people recover without issues, some may experience complications such as narrowing of the anal canal due to scar tissue or anal stenosis. Hemorrhoids can also recur if underlying causes like poor bowel habits are not addressed. Although rare, there’s also a risk of infection, including life-threatening blood infections, which require immediate medical attention.

By understanding what to expect after surgery and following your healthcare provider’s guidance, you can navigate the recovery process more comfortably and reduce the risk of complications.

Nonsurgical Alternatives

Several nonsurgical options can help ease hemorrhoid symptoms for patients who are not ready for surgery. One is rubber band ligation. In this procedure, a tiny band is tied around the hemorrhoid to restrict blood supply so it naturally shrinks and falls off over time. Another option is infrared photocoagulation, which uses heat to shrink the hemorrhoid by reducing blood flow to it.

For milder cases, over-the-counter creams or witch hazel can help reduce pain and swelling. Eating fiber-rich food, adequate hydration, and avoiding long periods of sitting can also prevent hemorrhoids from getting worse. By trying these nonsurgical approaches, you can manage symptoms without needing more invasive treatments.

Conclusion

Surgery for piles is typically reserved for severe or recurrent cases that don’t respond to conservative treatment. While surgical procedures can provide long-term relief, they also come with risks and require careful postoperative care. If you’re experiencing persistent or severe hemorrhoid symptoms, consult a piles specialist or healthcare professional to explore your options.