Haemorrhoids (Piles) and/or rectal Prolapse
Introduction
You will soon be treated in Bronovo Hospital for haemorrhoids (piles) and/or rectal prolapse.
In this leaflet, there is information about what will happen during the treatment. Problems arising from haemorrhoids and rectal prolapse differ for each individual patient. Your surgeon will decide which method of treatment is applicable in your own case.
Attention
Before the treatment, you should inform the doctor, who is dealing with your case, if you are taking Sintrommitis (Acenocoumerol), Marcoumar (Fenprocoumon), Voltaren, Brufen or painkillers containing acetyl salicylate such as APC, Aspirin, Ascal, Asprobruis (soluble Aspro). This is because these medicines can possibly cause bleeding during and following the treatment.
What are haemorrhoids?
Haemorrhoids are overstretched protrusions in the rectum that are situated just above the anus. These protrusions are spongy veinous masses covered with mucus. They act as “cushions” within the rectum to keep the area air- and watertight.
What causes Haemorrhoids and rectal prolapses?
If there is too much strain on these “cushions”, they can become stretched and saggy and even protrude from the anus. Prolapse of these cushions can feel uncomfortable and painful. Due to the pressure on the blood in the veins, haemorrhoids can easily bleed. Increased pressure can also lead to prolapse of the mucous membrane (inside coating of the rectum). This can also cause bleeding.
There are several causes of increased pressure:
- Lack of fibre-rich diet so that the faeces become too hard and difficult to pass
- Long and hard straining
- Not enough physical exercise; too much sitting
- Overweight
Types of treatment
If the protrusion is small, a “simple” Outpatients’ Department treatment will be sufficient. However, if the prolapse is large, an operation will be necessary.
Treatment in the Outpatients’ Department
The protrusions and/or a rectal prolapses will be bound with small rubber bands and restored to their normal position. This is called “Rubber Band Ligation”. It is not painful – no anaesthesia will be required –and takes about ten minutes. It is performed in the Endoscopy Department and is combined with a Protoscopy (see Bronovo leaflets). A protoscopy is necessary because the clinician needs to look clearly into the rectum.
In most cases, only one treatment is enough. Sometimes, however, a second or third treatment will be needed.
Surgical treatment
- You will be given an enema. This means that fluid will be passed into the rectum to empty and clean it thoroughly.
- Depending on your talk with the anaesthetist, you will either be given a general anaesthetic or an epidural (injection into the spine).
- A 3 to 4 centimeter section of the mucous membrane in the rectum will be cut out. The edges of the incision will then be fastened together with clips. This tightens the mucous membrane and so the haemorrhoids and the prolapse are pulled back into the rectum.
This operation takes about 30 minutes and can normally be done as a Day Treatment. It can happen that you may have to stay longer in the hospital but not more than two days.
After the treatment
After the Outpatients’Department treatment
For 1 or 2 days, you may experience an unpleasant feeling in the lower abdomen. You can take Paracetamol for this. A warm bath or shower can help to reduce this discomfort.
After 1 or 2 days, you can resume your normal daily activities. If necessary, you will come for a check-up at the Outpatients’ Department or the Endoscopy Department.
After the surgical treatment
The area of the operation will be swollen and painful for a few days. You will be given painkillers for this. In the first week, passing faeces that may possibly be bloody can be painful. When you go home after the operation, you will be given a prescription for both painkillers and a laxative.
After 1 or 2 weeks, you can resume your normal daily activities. A post-operative check-up will be done in the Outpatients’ Department 1 or 2 weeks after the operation.
Possible complications
The treatment of haemorrhoids and rectal prolapses is a procedure with a quick recovery period and usually without complications.
With any operation, however, there is a chance that complications can occur.
After the Outpatients’ Department treatment
- After treatment with the Rubber Band Ligation (small rubber bands), you could experience a persistent nagging ache in your lower abdomen. You might also notice slight bleeding. This usually lasts for a few days but not more than 14. If you are bleeding heavily (more than a full teacup), you should immediately contact the Accident and Emergency Department (Spoedeisende Hulp) or the Duty Surgeon.
- Problems passing urine. When you really are unable to urinate, you should contact the hospital.
After the surgical treatment
Following this treatment, risks such as infection of the wound, post-operative bleeding, temporary difficulty in passing urine and slight fever can occur. If you are worried by any of these, you should contact your family doctor (G.P.) or the surgeon who performed the operation.
Telephone numbers:
Accident and Emergency Department: (Spoedeisende Hulp): 070 - 312 44 45
Surgery Outpatients’Department: 070 - 312 43 61
Advice
Some years later, the haemorrhoids may possibly recur.
You can try to prevent this happening by:
- Eating a high-fibre diet and drinking plenty water
- Not delaying going to the lavatory when you feel the need to pass faeces
- Trying not to strain when passing faeces
- Taking plenty physical exercise. This stimulates the working of the bowels and regular passing of the faeces.
Conclusion
If, having read this leaflet, you have any questions, please do not hesitate to contact your surgeon. And, if you have urgent questions or problems before the operation, it would be best to contact the department where the operation will take place. Telephone: 070 - 312 46 93.
When problems arise at home after the operation, contact either your family doctor (G.P.) or the hospital.