Hemorrhoidectomy, complications and recovery after hemorrhoidectomy

Hemorrhoids in themselves are a very unpleasant disease. To get rid of it, most often you have to perform surgery. Against the background of such treatment, the process of rehabilitation after hemorrhoid surgery can be very unpleasant and lengthy. If we talk about the recovery time, then everything directly depends on the actions of the patient himself. If he follows the necessary recommendations, then in this case healing proceeds much faster. However, in some situations complications can occur.

In this case, the rehabilitation period after hemorrhoid surgery is slightly delayed. Therefore, it is important to understand that much depends on the patient’s actions. If he ignores the advice of doctors, he will have to wait longer for recovery.

How long does it take for hemorrhoids to heal?

First of all, it is worth saying that the minimum rehabilitation period after hemorrhoid surgery is at least 3 weeks. The maximum duration of this period can be up to 5 weeks. A quick recovery can be expected if the patient does not experience serious complications. This happens quite rarely. Most often, patients note that rehabilitation after hemorrhoid surgery is quite quick.

However, everything depends on the patient’s behavior after the procedure. The first weeks after surgery you should spend most of your time in bed. With any careless movement there is a risk of developing re-inflammation.

According to reviews, rehabilitation after hemorrhoid surgery is complicated by the fact that after a week patients begin to feel relief. Therefore, they move more often and allow themselves physical activity. However, to speed up recovery, you must adhere to strict rules during the first 2-3 weeks.

Only after 14-21 days can you start walking and allowing yourself minor exercise. It is very important that during rehabilitation a person adheres to physical activity standards. This means that you should never lift anything heavy during the postoperative period.

Good to know

To shorten the rehabilitation period after surgery to remove hemorrhoids, a person should not experience stress, since even a poor emotional state can lead to a longer healing process.

In addition, it is necessary to adhere to special diets and periodically take medications to speed up healing. They are prescribed only by a specialist who can prescribe a specific dosage. Depending on how the recovery of a particular patient occurs, it is imperative to visit a specialist so that he can observe the healing process and, in the event of secondary inflammatory processes, can prescribe therapy.

During rehabilitation after surgery for hemorrhoids on the rectum, it is equally important to observe the rules of hygiene of the anus, as well as the genitals. The recovery period directly depends on all these points and how well the patient adheres to the rules.

Possible complications

After an operation of this type, additional problems often appear, which significantly prolong the rehabilitation period after hemorrhoid surgery. Sometimes troubles occur immediately after surgery. It also happens that discomfort, secondary inflammation and other problems appear much later.

Most often, after surgery, according to reviews, patients experience problems with urination. As a rule, men experience such complications more often. Impaired urination may occur within 1 day after surgery. This is because anesthesia was used during the procedure. That is why after the operation it is advisable to insert a catheter, with the help of which urine will be drained artificially. As a rule, after a few days the unpleasant symptoms disappear and a fluid drainage device is not required.

In addition, when considering how long rehabilitation after hemorrhoid surgery lasts, it is worth paying attention to other possible complications, which patients sometimes talk about in their reviews. For example, almost everyone experiences quite severe pain in the rectum and anus. This is explained by the fact that there are many nerve endings in this area. After the anesthesia wears off, patients begin to feel very severe and unpleasant pain. To get rid of these symptoms, your doctor may prescribe painkillers.

In rare situations, rectal prolapse occurs after the procedure. This complication is considered one of the rarest. It can occur if the surgeon performed incorrect actions or inadvertently damaged the neuromuscular fiber. To get rid of the problem, conservative or surgical treatment will be required.

In the first stages of rehabilitation after hemorrhoid surgery, many people complain of bleeding. Typically, such symptoms are observed immediately after surgery. This is explained by the fact that during the procedure, specialists did not cauterize or pierce the blood vessels well enough. This leads to the fact that even the slightest movements can cause the patient to bleed.

The anal passage often narrows, fistulas, suppuration and much more appear. If certain complications appear after the procedure, then in this case it is difficult to say how long rehabilitation after hemorrhoid surgery will take. First of all, the doctor needs to get rid of the problems that have arisen and only after that can we talk about a full recovery.

Treatment, complications and lifestyle after hemorrhoid surgery

Negative consequences after a properly performed operation are rare. The fears that circulate on thematic forums are not justified, but you need to be aware of possible complications. This is especially true for such a serious operation as hemorrhoidectomy. Undesirable symptoms can appear both immediately after the procedure and some time after excision of hemorrhoidal veins. Among the most common complications:

Ishuria. Urinary retention is more common in men. This condition is observed one day after surgery. The risk of developing ischuria increases if epidural anesthesia was used. In this case, urine is drained with a catheter within 24 hours, and then the condition returns to normal spontaneously.
Bleeding. Blood discharge may be subtle or intense. Most often, this symptom is observed several days after surgery, when compacted feces injure fresh scars and sutures. Hemorrhoids may bleed after excision and due to the fact that the vessels were not cauterized enough. The crust may fall off during bowel movements. At the first signs of bleeding, you should tell your doctor about the problem. He will find a way to stop the bleeding and, if necessary, resew the damaged vessel. Near the anus, a clean gauze pad with ointment that absorbs the ichor should be kept constantly during this period. By the way, the release of ichor is the norm, since an open wound always releases exudate. In this case, cotton pads are not an option; they swell, complicating the situation. There is no talk of toilet paper. If the ichor does not allow you to leave the house and a napkin is not enough, protect your underwear with a feminine pad.
Pain syndrome. Pain after hemorrhoid surgery is common. The wound is cleaned and blood is released. The mucous surface of the intestine and the rectal valve have many nerve endings. After the end of anesthesia, pain always appears. If you have a low pain threshold, use painkillers. The burning sensation after defecation is not eliminated by anesthetics, you will have to put up with it.
Prolapse of the rectum from the anus. This rare complication occurs due to a surgeon’s error, which provokes dysfunction of the anal sphincter.
Infection. Infection can occur when the patient or doctor violates the principles of hygiene. When infection enters the wound, suppuration develops. The problem is eliminated with antibacterial medications; if necessary, the postoperative suture is opened and washed. On the fifth to seventh day, a grayish film similar to pus may appear. This is fibrin - a substance that covers wounds until they are cleansed. This is a normal physiological process, there is no need to worry about it.

Stricture. A narrowing of the diameter of the anus is possible due to improperly applied sutures. The size of the anus is increased using special dilators or plastic rectal surgery.
Fistulas. For the postoperative period, this is a fairly rare complication. It develops when the edges of the wound are inaccurately sutured, when other tissues are also captured at the same time. When an infection occurs, inflammation develops with the formation of pathological channels. It is imperative to eliminate the problem (by conservative or surgical methods).

Consequences after removed hemorrhoids can manifest themselves not only on the physical level, but also on the mental level. Some patients are afraid of pain during defecation, because feces must pass through the wound surface and this condition causes psychogenic constipation. They eliminate the problem comprehensively: in addition to consulting a psychologist, laxatives may also be required.

After surgery, the urge to defecate usually becomes more frequent. Sometimes they are false, since there is no feeling that the intestines are completely cleansed. Wounds in the anal canal do not always allow the sphincter to react adequately, since the brain does not control this situation well, so it holds weakly. If you didn’t make it to the toilet this time, don’t worry, this is normal for a postoperative condition.

Treatment of hemorrhoids is carried out using several methods depending on the stage of development of the disease. Acute hemorrhoids are treated by a proctologist using conservative treatment - phlebotropic drugs, ointments, gels, suppositories for hemorrhoids. The chronic form of hemorrhoids, accompanied by bleeding, is treated using minimally invasive techniques; the disease at a late stage is treated with surgery.

Postoperative complications most often occur in older people and patients who do not follow doctor's recommendations. In 5% of elderly patients in the study group, complications developed after surgery:

3% of patients experience acute urinary retention (ischuria).
1% of elderly patients – bleeding develops.
Less than 1% – vascular thrombosis, suppuration develops, and severe pain occurs.

Older patients undergo careful preparation for surgery and a full examination, which minimizes the risk of complications. At the Yusupov Hospital, patients are given a set of exercises involving the muscles of the buttocks, abdominals, anal sphincter, and a diet that regulates the consistency of intestinal contents and prevents the development of constipation.

The technical difficulties and traumatic nature of classical hemorrhoidectomy can cause negative consequences. Many patients refrain from undergoing surgery due to possible severe complications. These include;

acute urinary retention in men in the early postoperative period;
bleeding;
strictures (narrowing) of the rectal canal;
insufficiency of the anal sphincter;
involuntary bowel movements and urination;
difficult bowel movements;
anal fissure;
perirectal fistula;
tissue necrosis;
rectal prolapse;
hematoma;
infection;
relapse of the disease.

Acute urinary retention occurs in men after the use of epidural anesthesia. The condition is temporary. During this period, a urethral catheter is installed in a hospital setting.

Spontaneous urination or defecation occurs due to damage to the muscle or ligament in the anal ring (canal) during surgery.

Bleeding that occurs in the postoperative period may be due to impaired homeostasis when the integrity of the vessel is damaged or the falling off of an already formed crust.

The appearance of a crack can be caused by hard feces during defecation, which injure the wound in the wall of the rectum. If it becomes infected, a fistula may appear.

A submucosal hematoma can form due to a large accumulation of blood. Its size can reach large sizes - cases are described when it completely blocked the rectal canal. You can only get rid of it surgically.

Operations can be performed with an electric scalpel or laser. Since hemorrhoids are a vascular disease, the instrument for surgical treatment must have good cutting properties and coagulating characteristics. The electric knife has better characteristics than other tools. The advantages of laser surgery, radio wave and ultrasonic scalpel are relevant in proctology, but in most cases they are not of fundamental importance for the removal of nodes.

Surgical treatment almost immediately alleviates the patient’s condition. But in 5%, a relapse can occur up to 5 years after surgery; in 30% of cases, a relapse develops over the next 5-10 years if the patient does not normalize:

stool, relieving constipation;
nutrition by stopping eating junk food;
Lifestyle.

In addition, you must:

give up bad habits (alcohol and tobacco increase constipation and contribute to inflammation of hemorrhoids);
exercise and do special exercises to prevent hemorrhoids.

If the regimen is violated, bleeding and discomfort may recur after 3-5 years. In a third of patients who have undergone hemorrhoidectomy, the resulting nodes fall out again. This is due to non-compliance with the correct lifestyle. When hemorrhoidal cones are removed, cavernous tissue remains in the submucosal layer of the rectal canal. Significant static loads, a sedentary lifestyle, and constipation contribute to the return of pathological symptoms.

Rehabilitation rules

During the surgical intervention, the inflamed lumps are completely excised, which makes it possible to get rid of the unpleasant pathology. As a rule, such procedures are performed at the last stage if conservative therapy has proven completely ineffective. It is believed that after such procedures no serious complications can arise. However, doctors strongly recommend adhering to all the rules of rehabilitation after surgery for hemorrhoids of the 3rd degree or another stage. The recovery process may vary depending on the individual patient. It is necessary to take into account his age, health status and other indicators.

As a rule, on average healing occurs from 3 weeks to several months. Regardless of the recovery plan that the doctor has drawn up, for the first 5 days the patient must remain in a hospital setting under the supervision of a doctor.

During the first days he is prohibited from eating any food. If the patient ignores these recommendations, he will have stool, which can lead to serious injury to the sutures and longer healing.

Patients also need to undergo periodic dressing changes. During these procedures, antibacterial ointments and healing creams are used. Additional drug therapy is often required. A person must take medications in the dosage prescribed by the doctor after discharge.

Although the patient can stay at home, this does not mean that he can immediately return to normal activities as before the operation. Walking is permitted only after consultation with a doctor.

If we talk about sports activities, then you will have to forget them for the first 3 months of rehabilitation after surgery to remove hemorrhoids. If complications arise after surgery, this period will increase.

Under no circumstances should you lift heavy objects for a month, and in order not to experience pain, it is recommended to purchase special pillows that are installed on a chair, sofa, car seat, etc. Under no circumstances should you visit saunas, steam baths and other establishments with elevated temperatures. To speed up the recovery process, the doctor often prescribes special medications.

Complications after hemorrhoidectomy

The operation does not cause problems, but sometimes unpleasant consequences occur:

pain during bowel movements;
large blood losses;
involuntary passage of urine and feces;
tissue necrosis;
the appearance of hematomas;
fear of going to the toilet;
recurrence of hemorrhoids;
formation of blood clots in the veins of the legs;
development of infection;
swelling;
constipation;
sepsis.

Edema

One of the complications of hemorrhoidectomy is swelling of the mucous membranes of the anus and the outer surface. There are several reasons for this:

errors during surgery;
allergies to medications;
the result of cutting tissues and the features of their structure.

On average, swelling goes away within 2 weeks. To speed up the process, doctors prescribe to the patient:

Detralex to increase vascular tone;
Ibuprofen to relieve inflammation;
Heparin ointment , which reduces swelling;
Relief Ultra suppositories to eliminate swelling and relieve pain.

Relapses

According to doctors' observations, more than half of patients experience hemorrhoids again after surgery. Reasons for relapse:

violation of doctor's advice;
excess weight;
passive lifestyle;
poor nutrition;
frequent constipation;
alcohol consumption.

To avoid recurrence of the disease, follow these recommendations:

Follow your diet.
Get rid of excess weight.
Move more.
Walk.
Avoid constipation.
Stop drinking alcohol and smoking.
Don't lift heavy objects.
Go to the toilet when you feel the urge to defecate.
Maintain hygiene in the anal area.

Regenerative treatment

According to reviews, rehabilitation after hemorrhoid surgery is often accompanied by inflammatory processes, which are very difficult to avoid. Swelling, pain and other unpleasant symptoms also appear. To slightly improve the patient’s condition, experts recommend using creams with nitroglycerin (“Nitrocor”). They help relieve spasms that occur in the sphincter. This reduces pain not only during rest but also during bowel movements.

Analgesics (Ketanov, Pentalgin, Etodin Fort) may also be required. However, they are recommended to be used only when severe pain occurs; you should not proceed to the full course of treatment. If there is serious inflammation, then to speed up rehabilitation after hemorrhoid surgery, the doctor may prescribe rectal suppositories (“Relief”, “Venarus”, “Detralex”). You can also alleviate your condition with the help of traditional medicine, for example, some use sitz baths with the addition of sage, chamomile, calendula and other soothing herbs.

Ice compresses help relieve pain and reduce inflammation. When used, the blood vessels narrow, which reduces pain in the anal area. If a person is constipated, he may need laxatives.

For which categories of people is surgery contraindicated?

Hemorrhoidectomy surgery can be dangerous. It is worth thinking about the benefits of surgery for older people, since in this case there is a risk of dangerous complications. Anesthesia can adversely affect the functioning of the nervous and cardiovascular systems. Various heart defects, arterial hypertension, previous myocardial infarction, mental disorders are conditions in which such a procedure is extremely dangerous.

Why is hemorrhoidectomy contraindicated for elderly patients:

a forced position on the back with bent legs causes a person to strain unnecessarily;
the mucous membrane takes much longer to heal, regeneration in the area of postoperative wounds occurs much more slowly;
there is a significant risk of disruption of regular urination;
the addition of bacterial flora, which contributes to the development of purulent-necrotic processes.

It is bad if the patient delays treatment or does not follow doctors’ recommendations. The discharge of a large amount of blood after defecation is an unfavorable symptom. Then the disease enters the final stage, in which palliative therapy is necessary, aimed at alleviating the serious condition.

Patients with contraindications to surgery should be treated with:

special suppositories that reduce itching, swelling after hemorrhoidectomy and promote normal bowel movements;
hygiene products with antibacterial and anti-inflammatory effects;
a special diet is prescribed after hemorrhoidectomy, which is hypoallergenic and aimed at enhancing intestinal motility;
therapeutic exercises, which consists of periodically tensing and relaxing the anal muscles.

For effective treatment of hemorrhoids, you should consult a proctologist.
This treatment has its pros and cons. It is quite difficult to predict the effectiveness of such methods. Such patients often experience complications after the intervention. Surgical methods rarely help to completely cure the disease, but help reduce unpleasant symptoms. Sometimes psychotherapy sessions are appropriate; confidential conversations with a psychologist will help the patient adapt to the disease. If blood is released in small quantities after defecation and the patient’s condition is not accompanied by anemia, then surgical intervention can be dispensed with.

Diet

One of the most important stages of rehabilitation after surgery for hemorrhoids and anal fissures is proper nutrition. Thanks to the diet, the patient can count on faster recovery.

First of all, you need to adhere to several generally accepted rules. For example, food should be taken in small portions, but more often (5-6 times a day). Under no circumstances should you overeat. This will lead to problems in the stomach and, accordingly, in the rectum. It is advisable to steam all dishes, stew, boil, bake, but under no circumstances fry. Also, the patient’s diet should contain the required amount of microelements, vitamins and other components that provoke a speedy recovery.

Experts recommend including plant-based foods in your daily diet, which help make bowel movements easier. It is worth paying attention to foods that contain more fiber. Thanks to this component, normal peristalsis is stimulated.

Nutritional Features

Doctors also recommend consuming a teaspoon of natural olive oil every day. Additionally, it is worth including more fish and meat dishes in your diet. You need to drink at least 2 liters of water every day. However, on the first day of rehabilitation after hemorrhoid surgery with a laser or other method, it is prohibited to consume any food or drink.

As a rule, on day 2 you are allowed to start eating low-fat broths or pureed cereals. Later the diet expands. However, it is very important to give up unhealthy foods.

Hemorrhoidectomy - what is it?

Hemorrhoidectomy has been popular since 1935. It was then that two surgeons first tried the surgical treatment of hemorrhoids.

What is prohibited to eat

After surgery, it is important to avoid certain foods that may cause gastrointestinal problems. This means that under no circumstances should you eat canned food, pickles, fried foods and processed foods (especially fast food).

You also need to give up smoked meats, sausages, hot, spicy, salty, sour, fatty meat broths, sweet pastries, ice cream, sweets, legumes, rice and pearl barley porridge, black bread, nuts, fatty fish, meat, carbonated water, strong tea and alcohol.

Hygiene procedures after surgery

How rehabilitation will proceed after hemorrhoid surgery and how many days recovery will take depends on the actions of the patient himself. If he chooses not to shower, wash his hands or do proper hygiene after going to the toilet, this can cause more inflammation and, in some cases, the development of infection.

Daily hygiene measures are among the most important in the recovery process after such surgery. Every day the patient must carefully monitor the cleanliness of not only the hands and body, but also the anus and genitals. This will help avoid unpleasant infections and speed up the tissue healing process. Accordingly, recovery will occur much faster.

Among the recommendations of specialists, there are no special manipulations that could significantly complicate life. Doctors and patients who have undergone this procedure say that first of all it is necessary to wash with warm water twice a day (morning and evening). It is also necessary to clean the anal area after each bowel movement.

The skin around the anal area should be dry. For this, it is best to use soft napkins. If their use causes pain, you can use a soft cotton cloth. When treating the anus, you need to move very carefully and slowly. It is necessary to understand that in this area, as a rule, the process of inflammation and healing takes place. Therefore, you should not provoke complications once again.

It is worth noting that doctors strongly do not recommend using toilet paper. It can cause damage and scratch the skin. This will lead to even more irritation and inflammation. Therefore, it is best to wash yourself with water after visiting the toilet using a shower or bidet. When the wounds have healed a little and the patient begins to experience relief, you can start using special wet toilet paper, which also does not cause serious harm or irritation.

Many people believe that using cosmetics can significantly alleviate their condition. Actually this is not true. The only thing recommended to use is liquid soap. However, you need to carefully read its composition. Soap should not contain a large number of additives, flavorings and substances with coloring properties. It is best to use intimate gel for these purposes. If a person can already leave the house and begins to visit public places, it is recommended to always have antibacterial wet wipes with him. If you have to go to the toilet outside the home, you must thoroughly clean the anus so as not to introduce an infection into it.

Preparing for hemorrhoidectomy

Before excision of hemorrhoids, the patient is prescribed a comprehensive examination:

Blood tests to rule out inflammation and infections, determine group, Rh factor, coagulation.
Tests for hepatitis, HIV, syphilis.
Fluorography and ECG.
Inspection of the intestine using instrumental methods and palpation.

Mandatory conditions for successful hemorrhoidectomy:

Do not take medications that thin your blood for two weeks before surgery.
Change your diet within 48 hours. Eliminate fatty and spicy foods, foods that cause gas formation - legumes, vegetables with a lot of fiber, baked goods.
The day before surgery, have a light breakfast and lunch.
Stop drinking water 12 hours before the procedure.

The day before, the intestines are cleansed with medications or an enema. On the day of surgery, the patient is prohibited from eating and drinking.

In the morning the patient needs:

remove hair from the surgical treatment area;
do an enema;
take a shower.