What is Piles Surgery (Haemorrhoidectomy)?

Pile surgery, medically known as 'haemorrhoidectomy', is a surgical procedure used to remove haemorrhoids (piles), swollen blood vessels in the rectum or anus that cause pain, itching, bleeding, and discomfort. This surgery is typically recommended when piles become large, painful, prolapsed, or do not respond to medications and other non-surgical treatments.

Haemorrhoids may develop due to factors such as chronic constipation, straining during bowel movements, pregnancy, obesity, or prolonged sitting. When symptoms become severe or recurrent, surgery may be required to permanently remove the affected tissue.

Piles surgery is considered an effective treatment for advanced or severe haemorrhoids, especially Grade III or Grade IV haemorrhoids, where the swollen veins protrude outside the anus and cause persistent symptoms.

Who May Need Piles Surgery?

Doctors may recommend piles surgery for patients who experience the following:

● Large or prolapsed hemorrhoids that extend outside the anus

● Severe pain, itching, or irritation around the anal area

● Frequent rectal bleeding

● Hemorrhoids that do not improve with medications or minimally invasive treatments

● Thrombosed hemorrhoids (blood clots inside hemorrhoids)

● Recurrent hemorrhoids affecting quality of life

A doctor will evaluate the severity of haemorrhoids and overall health before recommending surgery.

Types of Piles Surgery

Several surgical techniques may be used depending on the severity and location of haemorrhoids.

1. Hemorrhoidectomy

This is the most common surgical procedure, where the surgeon removes the swollen haemorrhoidal tissue using surgical instruments.

2. Stapled Hemorrhoidopexy

In this technique, a stapling device is used to reposition and reduce the blood flow to haemorrhoids, causing them to shrink.

3. Laser Surgery for Piles

A laser is used to shrink or remove hemorrhoids with minimal bleeding and faster recovery.

4. Rubber Band Ligation (Minimally Invasive)

A small rubber band is placed around the haemorrhoid to cut off its blood supply so it shrinks and falls off.

The choice of procedure depends on the size, type, and severity of hemorrhoids.

Piles Surgery Procedure

Piles surgery is usually performed in a hospital under local, spinal, or general anesthesia.

1. Preparation

Before surgery, doctors review the patient’s medical history and may perform diagnostic tests such as proctoscopy or colonoscopy to examine the rectum.

2. Anesthesia

Anesthesia is administered so the patient does not feel pain during the procedure.

3. Removal of Hemorrhoids

The surgeon removes or shrinks the hemorrhoids using surgical instruments, staples, or laser technology.

4. Bleeding Control

The surgical area is carefully treated to control bleeding and promote healing.

5. Closure

In some cases, the surgical wound is left open to heal naturally, while in others it may be closed with stitches.

The procedure usually takes 30–60 minutes, depending on the technique used.

Recovery & Aftercare

Recovery after piles surgery varies depending on the surgical method and the patient’s health.

Common recovery guidelines include:

● Rest for the first 24 hours after surgery

● Mild pain or discomfort during bowel movements

● Warm sitz baths to reduce pain and swelling

● High-fiber diet and adequate fluids to prevent constipation

● Use of stool softeners as prescribed by the doctor

Most patients return to normal activities within 2–4 weeks, although complete healing may take longer in some cases.

Risks & Possible Complications

Piles surgery is generally safe, but like any surgical procedure, it may involve certain risks.

Possible complications include:

● Bleeding after surgery

● Infection at the surgical site

● Pain during bowel movements

● Constipation or difficulty passing stools

● Urinary retention

● Narrowing of the anal canal (anal stenosis)

● Recurrence of hemorrhoids in rare cases

Most complications are temporary and can be managed with proper medical care and follow-up.

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Frequently Asked Questions

Piles surgery is a procedure used to remove or shrink hemorrhoids that cause severe pain, bleeding, or prolapse.

The surgery itself is painless because anesthesia is used. However, mild pain or discomfort may occur during recovery.

The procedure usually takes 30–60 minutes, depending on the type of surgery.

Most patients recover within 2–4 weeks, although full healing may take longer in some cases.

Hemorrhoids usually do not return after surgery, but recurrence may occur if underlying causes such as constipation persist.

Doctors often recommend avoiding spicy foods, alcohol, and low-fibre diets during recovery to prevent irritation and constipation.