Piles surgery (Haemorrhoidectomy)

What are piles (haemorrhoids)?

Piles (haemorrhoids) are swollen veins in and around the anal region. They occur in the lowermost part of the anus and can cause severe pain and discomfort because the blood vessels become enlarged and stretch the surrounding skin. Piles that bulge out near the anal opening are called external haemorrhoids; those on the inner part of the anal opening that you cannot easily feel are called internal haemorrhoids. Piles affect people of all ages and can be treated effectively—including with surgery when needed.

Symptoms of piles

Symptoms to look out for include:

• Bleeding: bleeding during or after passing stool is one of the most common symptoms and often indicates internal piles.
• Swelling: small balloon-like swellings around the anal region; the anus may feel tender.
• Anal pain: piles often cause pain in the anal region and can make it difficult to pass stool.
• Lumps near the anus: lumps on or around the anal surface.
• Anal itching: haemorrhoids can cause severe itching around the anus, usually on the outside.
• Slimy discharge: a slimy discharge with stool can be a symptom of piles.
• Sore skin: sore skin or skin sticking out after a bowel movement around the anus.

What causes piles?

Common causes include:

• Low-fibre diet: too little fibre leads to harder, smaller stools and straining when passing stool.
• Pregnancy: the enlarged uterus can put pressure on the colon and anus, often leading to internal piles.
• Heavy weight lifting: can increase pressure and contribute to piles.
• Constipation: straining to pass stool puts strain on the blood vessels around the anus.
• Prolonged diarrhoea: passing loose stool for a long time can also contribute to piles.

Diagnosis of piles

The surgeon will assess your symptoms before suggesting treatment. If you have signs of external piles, the affected area will be examined. If symptoms suggest internal piles, a rectal examination may be needed. Once the diagnosis is confirmed, we can discuss the best treatment—including surgery when appropriate.

When is piles surgery (haemorrhoidectomy) done?

Haemorrhoidectomy is surgery to remove piles. It is suitable when you have: very large internal haemorrhoids; internal haemorrhoids that still cause symptoms after non-surgical treatment; large external haemorrhoids that cause major discomfort and make it hard to keep the anal area clean; or both internal and external haemorrhoids. You will have general or spinal anaesthesia so you do not feel pain. The operation is typically done as a day case and you will usually go home the same day. Full recovery takes around 1 to 2 weeks. Long-term success depends largely on improving your bowel habits—enough fibre and fluids—to prevent constipation and straining.

Going home and care after piles surgery

Immediately after surgery you may receive a long-acting local anaesthetic for 6 to 12 hours of pain relief. If you are not staying overnight, you leave once the anaesthesia has worn off and you have passed urine; someone should drive you home. You can expect some pain afterward; your doctor will prescribe pain relief. For the first few days, stick to liquids and a plain diet (e.g. plain rice, bananas, dry toast, crackers, applesauce), then return to everyday foods and gradually increase fibre. Follow-up is usually arranged at 2 to 3 weeks. We advise on hygiene, diet, and when to contact us if you have bleeding, fever, or worsening pain.