If your piles are large, you might need surgery to remove them. This is called a haemorrhoidectomy.
We try to set a date for surgery that is convenient for you. However, this depends on the waiting list at the time of your appointment.
If your symptoms get worse while you are waiting for your surgery, please see your GP. There are some lifestyle changes that might help your symptoms and stop the piles getting worse.
You need to go to a pre-assessment clinic. We check your health and ask you questions about your medical history and medicines. At this appointment, we also talk to you about the surgery in more detail to make sure that you are medically well enough to have an anaesthetic.
Giving your permission (consent)
We want to involve you in decisions about your care and treatment. If you decide to have surgery to remove piles, we ask you to sign a consent form. This says that you agree to have the treatment and understand what it involves.
If you would like more information about our consent process, speak to a member of staff caring for you.
Your surgery usually takes about 30 minutes and you have a general anaesthetic. This means that you are asleep during the surgery and do not feel anything.
If you have day surgery, you should be able to leave hospital on the same day as your surgery. It is important to rest for the remainder of the day while you recover from the anaesthetic.
You need a responsible adult to collect you if you leave hospital on the same day as your surgery. This adult must stay with you for at least 24 hours while you recover from the anaesthetic.
You can expect some bleeding from your bottom after surgery. This is normal. The amount of blood should be less than an egg cupful each day.
Over the next few days, the bleeding should reduce. However, you might still have a small amount of bleeding or spotting for 6 to 8 weeks.
If your bleeding is heavy or lasts longer than a few days, go to your nearest emergency department (A&E).
There is a small risk of infection inside the bottom after surgery. If you get an infection, we can treat it with antibiotics.
Looking after your wound
Try to wash the area with water. It may be helpful to use a squirt bottle, which you can get from a chemist, or use a shower or bidet to clean your bottom. Pat dry, or use a hair dryer. You can use alcohol-free wet wipes, after going to the toilet. Avoid using dry toilet tissue.
Keep the area clean and gently bathe your wound in a warm bath each day, if possible. This might also help with your pain. Do not use soap, or put salt or any perfumed products in the water, until your wound has healed. These could irritate your wound site.
There is a dressing inside your bottom. It comes out when you go to the toilet to have a poo for the first time.
You might notice a mucous (slimy) discharge from your bottom for up to 6 weeks. This is normal. You might want to wear a pad to protect your underwear.
Pain and discomfort
You can expect pain after surgery. It is a difficult and painful healing process.
It might seem like the pain gets worse before starting to feel more comfortable. We give you painkillers and laxatives (medicine used to help you poo) when you leave the hospital.
It is important that you take your prescribed amount (dose) of painkillers regularly. This helps to keep you as comfortable as possible. You might not need to take them if you are not in pain. Always follow the instructions on the packet and never take more than the recommended dose.
You can also use Instillagel which is a local anaesthetic gel which we can prescribe when you are discharged.
Laxatives to prevent straining
It is important to keep your poo soft because your bottom is sore and tender after surgery. Taking laxatives after surgery helps to loosen your poo and stop you from straining when you have a poo. This reduces your pain. You may have to readjust your laxatives to get the right consistency.
You may feel the urge to go to the toilet even if there is no poo there. Do not keep straining on the toilet if there is no poo.
Having a pee
Some people find it difficult to have a pee (pass urine) through their penis after surgery. It can help to sit and relax in a warm bath and try to have a pee in the bath.
Returning to work and normal activities
Most people take about 2 weeks off work, but this depends on how you feel and if your job is active.
Build up to your usual level of activity gradually. You can do as much as you feel able to. However, avoid any heavy activity such as lifting, exercise or running during the first week or so after surgery.
Do not go swimming until your wound has healed.
You can have sex as soon as you feel comfortable.