Hemorrhoids: When to Consider Surgery and What to Expect

Q: Hemorrhoids: When to Consider Surgery and What to Expect

Hello： Stage III hemorrhoids are typically recommended for surgical intervention; however, it is important to understand that recurrence is still possible after hemorrhoid surgery. <br>If you prefer not to undergo surgery at this time, using hemorrhoid ointments and taking warm s

Sticky stools can cause discomfort during bowel movements?

Hello, Doctor.
Following your advice, I consulted a colorectal surgeon who confirmed that I have grade 3 hemorrhoids and that my rectum is fine at 6 cm.
I was advised to undergo a colonoscopy later since other internal examinations were not possible.
The doctor suggested that I might consider having hemorrhoid surgery at the same time, mentioning that I am still young and have a long life ahead, and that my hemorrhoids could worsen.
However, I am quite confused about a few things:
1.
The doctor told me to live normally and that I could be admitted on Friday night without any dietary restrictions, and then spend about five minutes on the colonoscopy on Saturday.
This seems different from what I found online regarding others' experiences, and I am unsure if this is accurate.
2.
Is it generally recommended to have surgery for grade 3 hemorrhoids? Currently, I do not have issues like rectal bleeding or anal fissures; I just take a long time to wipe after using the restroom.
I suspect this might be due to the hemorrhoids causing residual stool to get trapped.
Would having hemorrhoid surgery alleviate this issue?
3.
After hemorrhoid surgery, is it true that regardless of the type of surgery, one must remain bedridden for 3-7 days before being able to walk? Since it is not convenient for me to take leave from work, I plan to confirm this with the doctor later before deciding whether to proceed with surgery so soon.
I apologize for not being clear about my situation and not asking the right questions during the appointment, as I did not do my homework.
I will make sure to ask these questions during my next visit when I am admitted for the examination.
Thank you for your guidance.

Juer, 20~29 year old female. Ask Date: 2017/02/16

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello: Stage III hemorrhoids are typically recommended for surgical intervention; however, it is important to understand that recurrence is still possible after hemorrhoid surgery.
If you prefer not to undergo surgery at this time, using hemorrhoid ointments and taking warm sitz baths are also effective methods to alleviate the severity and symptoms of hemorrhoids.
Wishing you peace and good health.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/02/16

More Info

When considering surgery for hemorrhoids, particularly in the case of third-degree hemorrhoids, it is essential to understand both the condition itself and the implications of surgical intervention. Hemorrhoids are swollen veins in the lower rectum and anus that can cause discomfort, bleeding, and other symptoms. Third-degree hemorrhoids are characterized by prolapse, meaning they can protrude outside the anal canal and may require manual reduction.
1. Surgical Considerations: Generally, surgery is recommended for third-degree hemorrhoids, especially if they are symptomatic. While you may not currently experience significant issues like bleeding or fissures, the potential for worsening symptoms is a valid concern. Surgery can alleviate discomfort and prevent future complications. The decision to proceed with surgery should be based on a thorough discussion with your colorectal surgeon about your symptoms, lifestyle, and the potential benefits and risks of the procedure.

2. Preoperative Instructions: Your surgeon's advice to maintain a normal lifestyle and the lack of dietary restrictions before the procedure is not uncommon. Many surgeons prefer patients to remain comfortable and relaxed leading up to surgery. The plan for a colonoscopy the day before surgery is also standard practice, as it allows for a clear assessment of the colon and rectum, ensuring no other underlying issues are present. The quick colonoscopy procedure, lasting only about five minutes, is typically well-tolerated and can be performed with minimal preparation.

3. Postoperative Recovery: After hemorrhoid surgery, recovery times can vary based on the type of procedure performed (e.g., hemorrhoidectomy, stapled hemorrhoidopexy). Generally, patients may need to rest for several days post-surgery, but many can begin moving around within a day or two. The recommendation for bed rest can range from 3 to 7 days, depending on individual circumstances and the extent of the surgery. It is crucial to follow your surgeon's specific postoperative instructions, which may include pain management, dietary modifications, and activity restrictions.

4. Work Considerations: If you are concerned about taking time off work, it is advisable to discuss this with your surgeon. They can provide guidance on what to expect in terms of recovery and when you might be able to return to your regular activities. Many patients can resume light activities within a week, but it is essential to listen to your body and not rush the healing process.

5. Long-term Outlook: Surgery for hemorrhoids can significantly improve quality of life by alleviating symptoms and preventing recurrence. While there is a possibility of developing hemorrhoids again in the future, especially if lifestyle factors (such as diet and bowel habits) do not change, many patients find relief from their current symptoms and a reduction in the frequency of flare-ups.

In summary, while the decision to undergo surgery for third-degree hemorrhoids can be daunting, it is often the best course of action to prevent further complications. Ensure you have a thorough discussion with your surgeon about your concerns, the procedure, and what to expect during recovery. This will help you make an informed decision that aligns with your health needs and lifestyle.

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