Should I have a hemorrhoidectomy

[kerry19834]

I have had piles for around 5-6 years, I have a very large skin tag/piles which dangles from my bum and then a large internal one.

The internal one bleeds after about 1/3 of bowl movements, bright red blood in the loo. Sometimes this will be once or twice a week and others it can be for 2 weeks straight of bleeding after a poo.

In a good month it might only bleed four times.

I have no pain or itching, just some discomfort and a couple of times a year they bleed randomly through my clothes

I eat a high fibre diet and drink lots, and can be done on the loo very quickly most times (I used to sit a lot and scroll on my phone).

I exercise regularly , yoga, running (marathons) and weights in the gym. They keep my mental health good.

I have seen a consultant and he has recommended a hemorrhodectomy so cutting it all out. Part of me really wants it (a years wait for the op on NHS), but there are horror stories about recovery.

I am scared that it will be very painful (despite the surgeon saying that will last a couple of days), also reading on here recovery is more than two weeks which the NHS claim.

I am worried that I will not be able to exercise for months.

I am torn, it is obviously bad enough for the NHS to fund it and they might not again if I turn it down.

Questions what would people do? What experiences have people had with surgery?

Should I put up with blood in the bowl after poos?

Will it get worse over time if I do nothing?

Thnaks

My DSis had hers done a few years back. She had left it too long to have the simple op and had a section removed and then staples. She made a complete recovery but had to take movicol regularly so she doesn’t become constipated.
I thought I was heading the same way but since going through the menopause mine have drastically improved and don’t cause problems any more. However I do take hormone blockers post breast cancer and I suspect that very low oestrogen is the reason they have shrunk. When I had hormones they were very cyclical.

Oh wow, I didn't know that was a possibility.

I was born with a bowel condition treated when young by surgery which makes me prone to constipation and I've had issues with fissures reopening most of my life. Eek.

The risk of lifelong continence issues is what puts me off - as it is now it's annoying but not life altering

I would have thought twice if I knew it was a real risk. I guess all surgical risks are real, but I had it in my mind as one of those rare risks that doesn’t really happen.

Crikey I hadn't realized feccal incontinence was a risk

I am not a wimp. Four children, four c-sections, back to full time work within weeks of each birth (which I regret now, but that’s another issue). But I was left with piles, which I reckoned were painful. The surgeon said there would be some “discomfort” for the first couple of weeks. Never was there a bigger untruth.

Once the initial anaesthetic wore off the pain started. Every time I had a poo I’d go into spasms which would last for hours. This went on for weeks. I had to have six weeks off work and could have done with 12. I was left with a very small diameter passage for the poo to get through - anything larger than a small dog’s would cause a blockage. I took movicol for years.

Eighteen years later I’ve had no recurring piles and everything is fine, so I guess it was worth it - but the pain I was experiencing from my piles was nothing compared to that of the operation.

Those of you who’ve had treatment and no longer suffer from haemorrhoids, have you done anything differently? Was there any advice given?

I’ve been in hell all Christmas. Currently sat in the bath hoping to reduce the throbbing from my morning dump. I skipped all the Christmas food and stick to porridge, sprout and kale salads, etc but there’s no end in sight and my earliest gp appointment is in 3 weeks.

That sounds horrible beyond words , could I ask is the size of your pasage back to normal now or is it still a case of needing to take medication to help?

Did you have bleeding from your piles before the op? I have no pain just bleeding and a large grape/ penis hanging down.

I am really in two minds now. I just can't afford to be in discomfort for so long

How long ago did you have the op? It does take a while for everything to return to normal, you have to think they are cutting away pieces of flesh your body has to heal from and nerves have to heal etc, they prescribed me naproxen which worked well for me along with shoving lidocaine up there, also a very good spray which I used after childbirth is the spritz for bitz which is very good at healing wounds, apart from that I don’t have much advice it’s just time really and slow healing, in response to some of the other comments I was never warned about incontinence and have never suffered with any so is that an old complication that no longer occurs with more modern surgery? I had my op November 2022 and am absolutely fine now, no further complications………

My DH had this done after many years of the bleeding and discomfort. He also used to bleed through his clothes.

he was in overnight but I won’t lie - recovery at home is grim. I decamped to the spare room at his request.

You could hear him screaming in the bath room after each BM (that might be just him- maybe others have a higher pain threshold).

The worst is the first 2 weeks. the swelling and soreness and stitches pulling.

They give you lots of stool softeners etc which they don’t always get right at first (too much or too little) but once the dosage is sorted it helps.   He used ice pops in a sock to ease the swelling.  (Can never look at an ice pop now without that image 😂). 

Not posting to frighten anyone , just how it was for him. It does work to a point but he always has to be careful and aware of regular habits. You’d think in this day and age we d have something a bit less medieval to fix this. No idea of the Botox route. It wasn’t an option or offered.

@Ceecee2483 I've not had any ops but have been a piles sufferer for decades now and it's just getting worse and worse, so think I need to bite the bullet and go for some treatment beyond the usual suppositories and creams. But I'm just worried I'll have an op and they will come back again, so wondering what's different afterwards - if there's any advice given to stop reoccurrence. Or is it out of our control?

I had my surgery in 2015. I had one large internal haemorrhoid and one large external skin tag, but the surgery damaged my internal sphincter muscle and left me with permanent incontinence.

They never caused me any pain, it was just the occasional bleeding and the appearance of it that I disliked. But I still had them removed much to my now regret.

@JT69 this is what I'm afraid of. The haemorrhoids themselves cause me so much pain I can barely move - sitting, walking, even lying down is painful. Currently feel like I have a hot poker shoved up my bumhole and every time I move it radiates pain up through my body in waves. The op sounds even worse.

I have a fairly high pain tolerance usually, but not in the anal region it seems.

Poor you OP. You are really suffering. Not really any good options but hope you can make the best decision for you. My DH doesn’t regret it (I’ve just asked him) but it’s not the silver bullet patients hope it will be.

I’ve had two subsequent pregnancies since, still currently pregnant and larger than with my first two children and they’ve never come back, I think because the areas that are prone to them are taken away they just don’t seem to reoccur, if they did ever come back badly again I would have the op again. They did actually say to me at the time I could have another done but at the time I declined lol that was straight after the op though when I started to feel the anaesthetic wearing off 😵they don’t do stitches these days, the wounds are left open as they heal better, I had 3 internal, 4 external and skin tags taken away so did resemble a baboon previously……I’d get them taken away again in a heartbeat if I was in the same situation.

DF had the op about 40 years ago. He was in hospital for about a week and I remember that he sat on a donut for some time, probably a few weeks. I wasn’t privy to the details of his recovery. But my sense is that after six weeks or so things were fairly normal. I think if he had been in pain using the loo or unable to sit normally when driving, sailing and camping that summer I would have noticed.

DM discusses his health with me and I don’t think he’s had further problems in this area.

@kerry19834 everything is fine now, but it did take a few years, and I make sure I have a high fibre diet. I had (what I thought was) pain, but not much bleeding.

TBH in retrospect I wish I’d been offered more pain relief etc to deal with the piles rather than straight to the operation.

Been researching the Halo technique. Not offered on the NHS by the sounds of it but could be a less painful route

I’m currently 2 days post surgery. I had a large grade 4 prolapsed pile removed , a large skin tag and a few banded inside.
I was having so many flare ups and they were making me so miserable that this was the only option left.
I had tried everything else.
My consultant was very honest with me and said it will be painful after but that it will be so much better in the long run.

My surgeon was lovely and said that whatever I do, even if I think I’m feeling better, just keep taking the pain meds religiously. They sent me home with all of the meds, including antibiotics and a big bottle of lactulose to take twice daily.
I’m on codeine every 6 hours, 2 paracetamol 6 hourly and 2 ibuprofen, all spaced out and it seems to be working.
I’m also drinking prune juice and smoothies all day and trying to avoid any white carbs. The last two days I’ve just eaten small bowls of fruit and fibre when hungry and when I take my codeine.
I have been laying in bed on my side mostly and getting up every so often to gently walk around the house, but nothing too strenuous.
The sitz bath from Amazon has been a life saver and means you don’t have to get in the bath all the time.
I won’t lie, my BM today was pretty painful but nothing worse than when I previously had a flare up and was in pain.
The hospital gave me a sick note for 2 weeks but said I might need longer and just ask the GP to extend it.
So far so good but I’ll keep you posted.

That sounds really positive @Cupcake8212 , do please keep us posted! I hope the pain levels stay low and you have a swift recovery!

Question though - it's possible I'll have no help at home after mine due to DH deploying for a few months... If that were the case, do I need to borrow someone to help me with anything? We have a dog who'll need walking etc, plus no downstairs loo etc.

Good luck @Cupcake8212 . I'm keen to watch your recovery, too. I'd rate my pain last week 10/10, not sure I could cope with anything worse than it, so interesting to know your pain is similar to a bad hem episode so far. I wish pain came in a realistic scale level other than 'okay now that is the most pain I've ever felt' and the clock resets!

Thank you. I’ll definitely keep you posted.

If you’re able to then try to get someone to walk your dog.
I’m on Day 3 now and still spending most of my time in bed laying on my side. I find this position the most comfortable.
I think you’ll be fine at home alone, as long as you take all of the medication.

Day 3 Update
I had the best night sleep so far because I decided to not take the codeine at bedtime. I was absolutely fine all night. I just took paracetamol and nurofen both once in the night.

My absolute saving grace is the sitz bath. This sounds revolting but the only way I can have a bearable BM is to go while sitting on the sitz bath with very hot water in it. Then I empty it and refill straight away with more hot water and just sit there. (I’m very fortunate that my parents (73 and 80) have let me stay with them. So my lovely Mum empties the sitz bath for me.

I’m drinking 2 glasses of prune juice per day and drinking copious amounts of water.

As well as small bowls of fruit and fibre, I had some whole meal toast last night.
As I’m on codeine, which causes constipation, I’m very aware of not wanting to eat anything that could make things worse.

I think because you’re on regular pain relief (3 different types at the moment) the pain doesn’t last anywhere near as long as a flare up.
It’s strong when you have a BM but very quickly goes. I’d take this over a flare up any day.

Wow some of the experiences here are horrific!

I have always weighed up whether to do anything about mine, they're huge and external, I have no pain and no bleeding, but they do look horrid. The only issue I have is with getting properly clean after using the toilet, it takes lots and lots of paper and wipes to get fully clean.
After reading the painful and lengthy recoveries here I think I will leave them be. I developed them during my first pregnancy and he's now 14.