Most haemorrhoids are treated without surgery, with most patients benefiting from attention being paid to their diet and toilet or defecatory habits. The most common procedures for haemorrhoids if required are rubber band ligation or injection sclerotherapy.

When external haemorrhoids are large and/or when internal haemorrhoids are large and prolapse and cannot be reduced, or repeated minor procedures have failed to improve symptoms, excision of haemorrhoidal tissue known as a haemorrhoidectomy may be required, usually under a general anaesthetic.

If performed in conjunction with a colonoscopy you will have a full bowel preparation before surgery, and if performed alone you will have an enema prior to surgery.

Depending on the pattern of haemorrhoids will determine what type of haemorrhoidectomy you will have. Haemorrhoidectomy is associated with a fair amount of pain following the procedure, especially when you open your bowels. A nerve block in the area provides decent pain relief on the day, and medications will be given to hopefully minimise pain. The pain can last for one to two weeks following haemorrhoidectomy. You will be given specific instructions on the day of surgery, but they usually include regular warm salt or sitz baths, avoiding hard wiping of the area, the use of perianal pads, and taking of stool softeners, pain medicine, fibre supplements and possibly a laxative.

Following surgery there are risks of bleeding and infection, and longer term risks of anal narrowing and muscle damage, but it is best to discuss these with your doctor for more specific details related to your haemorrhoids and your planned surgery.

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