Haemorrhoids

Haemorrhoids are diagnosed by a detailed history followed by a rectal digital examination and proctoscopy. This is all done at the clinic itself.  The history will classically entail the passage of hard motions, bright red painless bleeding associated with motions and a history of constipation.

Treatments of haemorrhoids depend on the stage of this disease process.  Early stage haemorrhoids are successfully treated with a combination of high fibre diet, plenty of oral fluids, avoidance of straining during defaecation and local application of topical ointment.  Surgery is almost never warranted.

More advance stage haemorrhoids (stage III and IV) may require surgical intervation if all efforts at conservative treatment are unsuccessful.  Surgery can be done usually via an open technique or a stapler procedure.  Various other techniques can also be used in the surgical treatment of haemorrhoids, including rubber band ligation, sclerotherapy, photocoagulation etc.

In the last few years, increasingly use of laser for the treatment of haemorrhoids have facilitated an earlier recovery when this modality is indicated.

Patients are commenced on fluids and a diet 4 hrs after the surgery which itself may take upto one hour.  Patients are mobilised, including made to sit on the same day of the surgery itself.  Patients can be discharged typically the next day after surgery, or after the patient has had a bowel movement.

Follow – up include warm sitz bath, plenty of fluids and increased fibre in the diet, Stool softens are helpful at this stage.  Patient may notice some bleeding associated with motions after surgery, but this typically recedes and then stops by the end of the first week after surgery.

Patient can resume work about 3 – 4 days after surgery.

Discomfort that the patient experiences after surgery during a bowel movements gradually recedes to a minimum by about 2 weeks after surgery. 

Complete healing takes about 3 – 4 weeks.

Patient can resume work within 48 hrs of returning home. 

Typically travel can commence safely within 5 days after surgery.