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Hemorrhoids can be treated with different procedures at different stages. Smaller hemorrhoids might be treated with banding, a procedure that involves minimal pain. Larger hemorrhoids might be treated with Stapled hemorrhoidopexy, in which the surgeon removes the hemorrhoid and then staples the healthy tissue back into place. This method has faster recovery time but is more likely to need to be repeated. Larger hemorrhoids may have to be treated with a more complicated surgical procedure called hemorrhoidectomy.

Hemorrhoidectomy usually involves considerable pain. The anal area will be painful for two to six weeks. There are things you can do reduce that pain, but some of them require advanced planning.

  • You absolutely, positively don't want to be dealing with constipation after your surgery. Ask your doctor about a stool softener so bowel movement will be easier. Take a soluble fiber supplement that will absorb water inside your colon and also make stool softer. You don't have to drink so much water that you slosh, but you should drink six to eight glasses (three to four liters) of water every day unless your doctor tells you otherwise. Avoid whole grain fiber, which is insoluble, because it can interfere with the passage of food through your stomach.
  • Avoid straining when you use the toilet. If it's not ready to come out, don't force it.
  • Use a small stool to prop up your feet when you sit on the toilet. This places your hips in a squatting position and relieves pressure on your anus.
  • Use Tucks or baby wipes for personal hygiene after defecation, or better, use a bidet or Tojo toilet to clean with water. Do not use toilet paper, especially not scented or colored toilet paper. Toilet paper can cause irritation.
  • Don't lift anything so heavy it places a strain on your anus or move quickly until your surgical incision has healed.
  • Take a sitz bath in three or four inches (seven to ten centimeters) of warm water several times a day. Don't get the water too hot, and don't add soap. Dry off by patting your behind gently with a towel or by using a blow dryer with a diffuser to you don't burn the injured area.
  • Apply an ice pack several times a day to relieve pain. Do not apply ice directly to the skin. Use a pack or wrap ice cubes in a clean cloth you use once and put in the laundry.
  • Do not share bath cloths or towels with other members of your household, so you do not pick up skin infections.
  • If swelling is a problem, lie on your stomach with a pillow under your hips.
  • Avoid opioid pain relievers such as Vicodin, Oxycontin, and Percocet. They can cause constipation.

When do you need to go back to the doctor? If you pass out, of course, you need to be taken to an emergency room. If you have sudden chest pain or abdominal pain, call for an ambulance. Shortness of breath is also a sign of a possible medical emergency.

Other complications of hemorrhoid surgery are a signal to call a nurse on an advice line:

  • Call the advice line if you have bleeding that requires two gauze pads.
  • Call the advice line if you have pain that your prescription medication does not relieve. It is always better to get a different prescription pain reliever than to experiment on your own. It's never a good idea to use a friend's pain medication.
  • Call the advice line if pain and swelling are getting worse, not better, or if you have pus draining from a wound, or if you have a swollen belly with constipation. 
  • Call the advice line if there are red streaks leading to the wound, the wound feels warm, or you have a fever.

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