Haemorrhoids, often called piles, are swollen veins in the lower rectum or anus that can cause discomfort, pain, or even bleeding. For many people, home remedies like warm baths, creams, or diet changes can help. But when haemorrhoids get severe or don’t go away, surgery might be the best option.
If you’re considering surgery or want to know more about your options, you’re in the right place. Here’s a complete, easy-to-understand guide on haemorrhoid surgeries, recovery expectations, and how to choose the right procedure.
Types of Hemorrhoid Operations: Comparison
Here’s a quick look at the most common treatments:
| Procedure | Best For | Anaesthesia | Downtime | Pain Level |
| Haemorrhoidectomy | Large, prolapsed haemorrhoids | General | 2-8 weeks | High |
| Rubber Band Ligation | Small to medium internal haemorrhoids | None or local | 1-3 days | Low to medium |
| Haemorrhoidal Artery Ligation (HAL) | Bleeding internal haemorrhoids | General or spinal | 3-7 days | Low |
| Laser Haemorrhoidoplasty | Internal or external (mild to moderate) | Local or general | 3-5 days | Very low |
When Is Hemorrhoid Surgery Necessary?
Surgical treatment is typically considered in the following scenarios:
Severe Haemorrhoids: Grade III (haemorrhoids that prolapse and require manual reduction) and Grade IV (irreducible prolapsed haemorrhoids) often necessitate surgical intervention.
Non-Responsive to Conservative Treatments: When dietary modifications, topical treatments, and minimally invasive procedures fail to provide relief.
Complications: Such as thrombosed (clotted) haemorrhoids or significant bleeding.
Types of Surgeries to Treat Hemorrhoids
There are different types of surgeries for haemorrhoids. Some are simple procedures that you can get done without anaesthesia and don’t require a hospital stay, while others are more complex and need you to be admitted to the hospital. Your doctor will decide if you need surgery and what type is best based on how severe your symptoms are and if there are any complications.
Haemorrhoidectomy
What It Is: Haemorrhoidectomy is a full-on surgery where a surgeon cuts out the haemorrhoids completely.
Best For: Large internal or external haemorrhoids that cause serious pain or bleeding.
How It’s Done: You’ll usually be under general anaesthesia, meaning you’re asleep during the procedure, which takes about 45 minutes. You might stay in the hospital overnight. The surgeon uses a tool called a retractor to gently open your anus and get a clear view of the haemorrhoids. Then, they use a device called diathermy to cut away the haemorrhoid tissue and any extra skin tags. Sometimes, they’ll add a dissolvable stitch inside to block blood flow to the area. Afterwards, a special dressing called Spongostan is placed in your anus to control bleeding, and a local anaesthetic is injected to reduce pain right after surgery.
Recovery: Takes 2-8 weeks. You’ll feel pain for a few days, but medicines can help. Sitz baths (sitting in warm water) speed up healing.
Pros: Very effective for severe cases; low chance of haemorrhoids coming back.
Cons: More painful recovery, longer downtime.
Rubber Band Ligation (Banding)
What It Is: Hemorrhoid Banding Surgery isn’t a full surgery but a quick procedure. A doctor uses a small tool to place a tiny rubber band around the base of an internal haemorrhoid, cutting off its blood flow. The haemorrhoid shrinks and drops off in about a week, leaving a scar that stops other veins from bulging into the anus.
Best For: Small to medium internal haemorrhoids.
How It’s Done: Done in a doctor’s office without anaesthesia, it takes around 30 minutes. The doctor can treat one or two haemorrhoids at a time, but under general anaesthesia, more can be done in one go. If needed, additional treatments happen every 4-6 weeks.
Recovery: Some people go back to normal right away, while others take a few days off. You might feel pain, a full feeling in your lower belly, or an urge to use the bathroom. Avoid heavy lifting or straining while healing.
Pros: Simple, quick, no hospital stay.
Cons: Not for external haemorrhoids or very large ones.
Haemorrhoidal Artery Ligation (HAL)
What It Is: A less invasive option where the surgeon uses a Doppler ultrasound to find and tie off the arteries feeding the haemorrhoids, shrinking them over time.
Best For: Internal haemorrhoids causing bleeding.
How It’s Done: Usually done under general anaesthesia (you’re asleep), though some get spinal anaesthesia (numbing the lower body while you’re awake). Your doctor will pick the best option for you. A tube called a proctoscope is inserted to keep the anus and rectum open. Then, an ultrasound probe locates the blood vessels, and dissolvable stitches cut off the blood supply. If haemorrhoids are prolapsed, they’re stitched back into place. It takes 30 minutes to an hour.
Recovery: Minimal pain, back to normal in a few days to a week.
Pros: Low pain, quick recovery, no cutting.
Cons: Not for external haemorrhoids; may need repeat treatments.
Laser Surgery (Laser Haemorrhoidoplasty)
What It Is: A modern method using laser energy to shrink haemorrhoids from the inside, targeting just the problem areas for a safe fix.
Best For: Small to medium haemorrhoids, internal or external.
How It’s Done: A laser beam seals blood vessels and reduces the size of haemorrhoids, taking 30-90 minutes. For bigger prolapses, it can be paired with stitches (HAL-RAR) to hold everything in place. Done under local or general anaesthesia, no overnight hospital stay is needed.
Recovery: Swelling goes down in 1-2 weeks, and most people are back to work in 5-7 days.
Pros: Less bleeding, quick healing, precise, minimal downtime.
Cons: Expensive, not widely available everywhere.
Risks and Complications of Haemorrhoid Surgery
Haemorrhoid surgery is very common and generally safe, but like any operation, it comes with some risks. Here’s what could happen:
- Bleeding: Some extra bleeding might occur after surgery.
- Infection: The surgery site could get infected, though this is rare.
- Anaesthesia Issues: You might have a reaction to the anaesthesia used.
- Trouble Peeing: Swelling or muscle spasms could make it hard to urinate for a short time.
- Faecal Incontinence: If the anal sphincter (the muscle controlling bowel movements) gets damaged, you might leak stool or gas by accident—though this is uncommon.
Post-Surgery Aftercare
Here’s how to support a smooth and comfortable recovery:
- Take your pain medicine as your doctor tells you.
- Use stool softeners to make going to the toilet easier.
- Eat high-fibre foods like fruits, vegetables, and whole grains.
- Gently wash the area with warm water a few times a day.
- Avoid heavy lifting, hard exercise, and sitting too long.
- Sit in warm water (sitz bath) to ease pain and swelling.
- Don’t strain or push during bowel movements.
- Use soft toilet paper or baby wipes to clean gently.
When Should You See a Doctor for Hemorrhoids?
Contact your doctor immediately if you notice:
- Heavy and persistent bleeding that won’t stop.
- Trouble peeing or having a bowel movement.
- A fever, which could signal an infection.
- Ongoing pain and discomfort.
- Prolapsed haemorrhoids.
- Itching, burning, or irritation that won’t go away.
- Lumps around the anus.
When to Choose Surgery?
Surgery isn’t the first step; it’s for when other treatments fail. You might need it if:
- Haemorrhoids keep bleeding or hurting despite creams or lifestyle changes.
- They prolapse and won’t stay inside.
- Pain or itching is ruining your daily life.
Talk to a doctor to weigh your options. They’ll help you decide if surgery’s worth it.
Final Thoughts
Haemorrhoid operations can sound scary, but they’re a proven way to get rid of severe piles for good. There’s an option for every situation, from quick fixes like rubber band ligation to complete surgeries like haemorrhoidectomy. The key is knowing what to expect and following your doctor’s advice for a smooth recovery.
Book your consultation now and take the first step toward relief.
Frequently Asked Questions
1. How much does haemorrhoid surgery hurt?
Haemorrhoidectomy (the surgery to remove haemorrhoids) can be a little painful, especially in the first few days. The pain is usually worse right after the operation but gets a lot better within two weeks. You can manage it with pain medicines and warm baths to ease the discomfort.
2. Is haemorrhoidectomy a big deal?
The surgery itself isn’t super long or tricky, but the healing part can feel like a big deal. Recovery varies—some people are back to normal in a couple of weeks, while others might need up to eight weeks to feel fully better.
3. Is it worth getting haemorrhoid surgery?
If your haemorrhoids are severe or keep coming back despite other treatments, surgery could be a great choice. It might fix the problem, but it’s important to discuss with your doctor the pros and cons to see if it’s right for you.
4. What size haemorrhoids need surgery?
Doctors usually suggest surgery for bigger, more serious haemorrhoids, like Grade 3 (ones that stick out but can be pushed back in) or Grade 4 (ones that stay out all the time). It’s also an option if smaller ones don’t get better with other fixes.
5. Can you sit after haemorrhoid surgery?
For the first few days, go easy when you sit—don’t plop down hard, and avoid sitting for too long. You don’t need a pillow or cushion; just take it slow and gentle.
