Our Summary

This research paper studies the level of pain experienced by patients after different types of surgeries for severe hemorrhoids. The researchers wanted to understand which surgical procedure caused the least post-operative pain. They conducted a review and analysis of prior studies that looked at various surgical methods, including traditional open hemorrhoidectomy (the removal of hemorrhoids), closed hemorrhoidectomy, and other techniques that use special surgical tools like bipolar or ultrasonic sealants.

Their findings showed that none of the procedures resulted in severe pain after surgery. However, the most painful method was the traditional open hemorrhoidectomy, especially on the first and seventh days after the operation. Hemorrhoidopexy (a procedure that lifts and fixes the hemorrhoidal tissue back to its original position) caused the least pain, but it also had a higher rate of the hemorrhoids returning in the long term.

The researchers concluded that hemorrhoid surgeries can be performed safely in an outpatient setting (where patients go home the same day of surgery) and that post-operative pain can be managed effectively. They also suggested that closed hemorrhoidectomy, performed with special surgical tools and avoiding a specific technique (transfixive ligation of the hemorrhoidal pedicle), could lead to better pain control after surgery.

FAQs

  1. Which surgical procedure for severe hemorrhoids was found to cause the least post-operative pain?
  2. What are the potential drawbacks of Hemorrhoidopexy despite it causing the least pain?
  3. What suggestions did the researchers make for better pain control after hemorrhoid surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hemorrhoidectomy is to follow post-operative care instructions carefully. This may include taking prescribed pain medications as directed, keeping the area clean and dry, and avoiding strenuous activities that could strain the surgical site. It is also important to follow up with your doctor for any concerns or complications that may arise during the healing process. By following these guidelines, patients can help ensure a smoother recovery and minimize post-operative pain.

Suitable For

Patients who are typically recommended for hemorrhoidectomy are those who have severe hemorrhoids that do not respond to conservative treatments such as dietary changes, topical medications, and lifestyle modifications. These patients may experience symptoms such as persistent bleeding, prolapse, pain, and discomfort that significantly impact their quality of life. Additionally, patients with thrombosed hemorrhoids (clotted blood within the hemorrhoidal tissue) or large internal hemorrhoids may also be candidates for surgery.

It is important for patients to consult with a healthcare provider to determine if hemorrhoidectomy is the appropriate treatment option for their specific condition. The decision to undergo surgery should be based on the severity of symptoms, the effectiveness of conservative treatments, and the patient’s overall health and medical history.

Timeline

Before a hemorrhoidectomy, a patient may experience symptoms such as pain, itching, swelling, and bleeding in the anal area. These symptoms may have been ongoing for a long time and may have worsened over time. The patient may have tried conservative treatments such as over-the-counter medications, dietary changes, and lifestyle modifications before deciding to undergo surgery.

After a hemorrhoidectomy, the patient will experience some pain and discomfort in the anal area, which is expected after any surgical procedure. The level of pain experienced will vary depending on the type of surgical method used. The patient may also experience some bleeding, swelling, and difficulty with bowel movements in the immediate post-operative period.

Over time, the pain and discomfort will gradually improve as the surgical site heals. The patient may be prescribed pain medications, stool softeners, and sitz baths to help manage their symptoms. It is important for the patient to follow their surgeon’s post-operative instructions carefully to ensure proper healing and to prevent complications.

In the long term, the patient should experience relief from their hemorrhoid symptoms and an improvement in their quality of life. With proper care and follow-up, the patient should be able to return to their normal activities without the discomfort and pain caused by hemorrhoids.

What to Ask Your Doctor

  1. What type of hemorrhoidectomy procedure do you recommend for my specific case?
  2. What are the potential risks and complications associated with hemorrhoidectomy surgery?
  3. How long is the recovery period after hemorrhoidectomy surgery?
  4. What can I do to prepare for the surgery and optimize my recovery?
  5. What type of pain management options will be available to me after the surgery?
  6. How likely is it that my hemorrhoids will return after the surgery?
  7. Will I need any follow-up appointments or treatments after the surgery?
  8. Are there any restrictions or lifestyle changes I should make after the surgery to prevent the recurrence of hemorrhoids?
  9. How soon can I expect to return to work and normal activities after the surgery?
  10. Are there any alternative treatments or procedures available for hemorrhoids that I should consider before opting for surgery?

Reference

Authors: Balciscueta Z, Balciscueta I, Uribe N. Journal: Int J Colorectal Dis. 2021 Dec;36(12):2553-2566. doi: 10.1007/s00384-021-04013-6. Epub 2021 Aug 20. PMID: 34417639