Surgical Procedures
Hemorrhoid
What are hemorrhoids?
Hemorrhoids are veins around the anus that have become swollen, enlarged, and painful. External hemorrhoids are engorged veins at the anal opening, and internal hemorrhoids are veins inside the anal opening.
The body normally has heavy blood flow to the area around the anus, and the veins are already large. Although there are many causes, additional stress on these veins, such as pregnancy, liver disease, advancing age, obesity, chronic constipation, or a job that requires lots of sitting, could lead to hemorrhoidal congestion and pain.
How do I know if I have hemorrhoids?
Dr. Beutel will make the appropriate diagnosis, but these are some symptoms that may accompany hemorrhoids: rectal bleeding, bright red blood in the stool, and/or itching around the anus. Also, the hemorrhoids may protrude on the outside. External hemorrhoids may be very painful, especially if they become clotted.
Usually the best diagnosis comes through taking a careful history and a thorough physical exam. A painful external hemorrhoid is generally easy to identify, but Dr. Beutel may use an anoscope to see the area more clearly. An anoscope is small, lubricated instrument that allows the doctor to see the inside of the anal canal. Also, Dr. Beutel may order some tests, such as a colonoscopy or a CT scan, to make sure the intestines and organs are functioning properly.
I have hemorrhoids. What happens next?
Many hemorrhoids may be managed using non-operative techniques. Avoiding constipation (using stool softeners when necessary), losing weight (for overweight individuals), and getting up and walking around frequently (if a job involves much sitting) are some everyday lifestyle changes that may help. Also, Sitz baths (sitting in a warm bath for 15 minutes three times a day and after a bowel movement) and non-prescription creams to ease the itching and swelling may help.
For some people, the above measures are not enough and surgery becomes the best option. Dr. Beutel carefully discusses the alternatives with his patients. If surgery is indicated, the operation usually takes an hour or less, and most patients stay one night in the hospital.
What are the risks of the operation?
The operation nearly always has associated pain and minor bleeding during the first one to three weeks. More major bleeding which requires re-operation to control is a much less frequent occurrence. Perianal or rectal infection and urinary retention are other potential but not frequent complications.
What do I need to do to prepare for the surgery?
You will be given separate instructions at the office checkout and from the hospital. Be sure to follow these carefully. If you smoke, it would be best if you could stop or reduce the amount drastically. It will help your lungs during the surgery, and coughing less will diminish the stress on the sutures.
Related documents: 
Hemorrhoid post-operative instructions
