To remove internal or external hemorrhoids, the proctologist may recommend surgery, especially for people who continue to experience pain, discomfort and bleeding even after adopting an adequate diet and taking medication.
There are several surgeries to remove hemorrhoids, such as hemorrhoidectomy, sclerotherapy and infrared coagulation, for example, which are chosen by the proctologist according to the type of hemorrhoid the patient has.
Recovery from hemorrhoid surgery lasts between 1 week and 1 month, requiring you to stay in the hospital for about 2 days and maintain good hygiene in the intimate area during the recovery time.
Main types of surgery for hemorrhoids
Some techniques for removing internal or external hemorrhoids can be:
1. Hemorroidectomia
Hemorrhoidectomy is the most recommended surgery and involves removing the hemorrhoids through a cut. This procedure can be performed with general or local anesthesia, and is mainly indicated for grade 3 and 4 external or internal hemorrhoids.
2. Technique by THD / Endopex
This is a surgery performed without cuts, in which the doctor uses an ultrasound device to identify the vessels that carry blood to the hemorrhoids. Once these vessels have been identified, the doctor stops blood circulation by stitching the artery, which causes the hemorrhoid to close and dry over time, with the stitches being absorbed. This technique can be used for grade 2, 3 or 4 hemorrhoids.
3. PPH technique
The PPH technique allows hemorrhoids to be fixed in their original position, using special titanium clamps. This procedure does not require sutures, has a quick recovery time and is performed on grade 2 and 3 internal hemorrhoids.
4. Hair ligation with elastic
This is a treatment where a small elastic band is applied to the base of the hemorrhoid, which will interrupt blood transport and cause the death of the hemorrhoid, being common in the treatment of grades 2 and 3 hemorrhoids.
5. Sclerotherapy
In this technique, a product that causes tissue death is injected into the hemorrhoid vessels, being used to treat grade 1 and 2 hemorrhoids. Understand how sclerotherapy is performed.
6. Infrared coagulation
Infrared coagulation is a technique that can be used to treat internal bleeding in hemorrhoids. To do this, the doctor uses a device with an infrared light that heats the area and creates a scar on the hemorrhoid, making it impossible for blood to pass through and, consequently, the hemorrhoid tissues harden and end up falling out. Infrared coagulation typically has very few side effects and causes very little discomfort.
Classification of the degree of internal hemorrhoids
Internal hemorrhoids are those that develop and remain inside the anus, and can present different degrees, such as:
- Grau 1 – Hemorrhoid found inside the anus, with a slight increase in the veins;
- Grau 2 – Hemorrhoid that comes out of the anus during defecation and returns inside spontaneously;
- Grau 3 – Hemorrhoid that comes out of the anus during defecation and that needs to be reinserted into the anus with the hand;
- Grau 4 – Hemorrhoid that develops inside the anus but due to its enlargement ends up exiting through the anus, which can cause rectal prolapse, which is the exit of the final part of the intestine through the anus.
External hemorrhoids are those located on the outside of the anus, and these can also be removed through surgery, because they cause discomfort especially when sitting and defecating.
What is the post-operative period like?
Although the surgery does not cause pain, in the postoperative period it is normal for the patient to feel pain in the perineal region, especially when sitting and during the first bowel movement after surgery, as this region is more sensitive. Therefore, the doctor generally indicates:
- Use pain relievers to control pain and discomfort, such as paracetamol every 8 hours;
- Use laxatives to make stools softer and easier to evacuate;
- Take cold water sitz bathsfor 20 minutes, the number of times necessary to reduce discomfort;
- Avoid using toilet paperwashing the anal region, after evacuating, with warm water and neutral soap;
- Use an ointment advised by your doctortwice a day, to help heal the region.
After surgery, it is recommended to use a round buoy-shaped cushion to sit on, in order to reduce the risk of bleeding and reduce pain. Furthermore, during the first month after surgery, you should prefer foods rich in fiber and drink plenty of water, so that the stools are softer and easier to evacuate.
Check out the following video on how to eat to facilitate intestinal transit and avoid hemorrhoids:
What is the recovery time
Recovery from hemorrhoid surgery depends on the type and degree of the hemorrhoid and the technique performed, and can vary between 1 week and 1 month to be able to normally resume daily activities.
It is normal for the person to experience small amounts of blood loss in the anal region during the first week after surgery. However, if the bleeding is severe, it is recommended to go to the hospital to check if you are recovering properly.
