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Haemorrhoidectomy by Dr Peter Loder Sydney

What is a Haemorrhoidectomy?

Haemorrhoidectomy is an operation under General Anaesthesia to remove symptomatic haemorrhoids that are not treatable with rubber band ligation in rooms. It requires hospitalisation with an over night stay.

What can I expect after my operation?

It is not common to have severe pain in the early post-opeartive period. Moderate pain could be expected with bowel motions. Typically, the first bowel action will not happen for 2 to 3 days after the operation. A longer delay before recommencement of bowel activity is associated with more severe pain. A soft but formed motion is best. You will be given laxatives (by the hospital) to try to produce an early, soft motion.

Some seepage is normal post-op. It is common for this to appear pusy in character. This does not mean the wounds are infected. The anitbiotic Flagyl (which you will be prescribed) helps to minimise this and the associated discomfort. You should avoid drinking alcohol while taking this medication. Typically, the discharge is at its maximum from 8 to 12 days after the operation and this is the time in which most patients have the greatest discomfort.

How can I help the pain and/or discomfort?

Analgesics will be prescribed when you leave the hospital. When these run out, Panadol or Nurofen (but do not take anything containing Codeine, as this will cause constipation) will usually suffice. They should be taken regularly, especially before a motion. A small bath with salty, warm water (Sitz bath) or Lux flakes (do not use anything containing soap) is traditionally recommended and most patients find this to be soothing. Frequent bathing with no excessive movement or exercise and being sure not to overdo laxatives is the key to managing this difficult period.

What if I see blood?

A small amount of bleeding is normal until the wounds are fully healed. Vigorous bleeding can occur in up to 1% of cases. It remains a risk until two weeks after the operation. Blood thinning agents such as Aspirin and St. John’s wort should be avoided during this time, unless there is a strong medical reason to continue them.

If you have worrying bleeding, you should telephone the rooms during office hours or call the hospital where you had your operation or attend the nearest Emergency Department.

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