When You Just Can't Sit Down Anymore: Hemorrhoidectomy Time!

Hemorrhoids are those incredibly painful and extremely uncomfortable veins that swell within your anus. Pregnant women might suffer from them, but usually people inherit these conditions from parents who had similar anal vein problems. For most pregnant women, the hemorrhoids will go away after childbirth, but for everyone else, hemorrhoids may never fully leave. If your hemorrhoids have reached a catastrophic point where they are so swollen that you cannot sit down, and the hemorrhoids themselves are massive lumps preventing defecation, it may be time to consider a hemorrhoidectomy surgical procedure to remove the troublesome veins. Here is how a proctologist will assess and treat your situation. 

Visual Exam

When hemorrhoids are so immense that you are looking at golf ball- to softball-sized lumps in your anus and buttocks near your anus, the proctologist does not have to do much more than a visual exam. However, he/she might lube a rectal scope and gently insert the scope a few inches (or as far as the swelling will allow) to see how bad the situation is. Then he/she will determine what the next step toward surgery is, which may require reducing swelling of the tissues just enough for you to receive an enema and then nothing to eat for twelve hours before surgery. 

Applying a Medical Grade Antihemorrhoidal Cream to Reduce Inflammation

Any sort of surgery requires that your bodily system be free of waste. With hemorrhoids as large as the ones you are experiencing, this is going to be difficult because you cannot pass stool without pain (or you cannot pass stool at all). Your doctor will have you apply a medical grade antihemorrhoidal cream/ointment to the enlarged hemorrhoids. This should help reduce the swelling just enough to administer an enema, which you can choose to do at home, or wait to do at the hospital overnight. Once the doctor is certain that all stool has passed and will not cause an infection to the surgical site, they can proceed with the removal of the hemorrhoids. 

Local Anesthetic, Followed by Cutting and Removing

Either a saddle block type of anesthetic (epidural) or just a local injected into the anus and rectum is sufficient. Most patients remain awake for a hemorrhoidectomy procedure, but that is ultimately up to your doctor. Then he/she will use a cauterizing scalpel to cut out the offending veins and swollen tissues. After he/she has removed sufficient vessels and tissues, then stitches are placed in the cauterized incisions to ensure that any slight straining during defecation will not cause the wounds to reopen. You are given care instructions and sent home with a donut cushion to sit on for the next few weeks.