HAVING AN OPERATION FOR PILES
Surgery for piles has a reputation for being very painful. Nowadays much of the pain can be prevented. We use the following methods to do this.
- Four days before surgery, you start taking Movicol so that your bowel motions are loose after the operation.
- During the operation, long-acting local anaesthetic is used to anaesthetise the anus for some hours afterwards.
- Before your bowels act (not afterwards) you take a painkiller and straight afterwards you get into a hot bath.
- If your anus burns after a motion, Anethaine cream (a local anaesthetic) usually helps.
Before the operation
The preparation starts four days before the operation, when you start taking a laxative. Take enough Movicol to make your motions loose. Aim for 2-3 loose motions a day. After the operation, take Movicol every day until you feel comfortable without it. If you want less runny motions, take two sachets a day of Fybogel instead, as it produces formed but soft motions. Movicol and Fybogel need no prescription.
You will be admitted to hospital an hour or two before the operation. The operation itself takes about an hour.
After the operation
Immediately after the operation your anus should not hurt. If it does, ask for a painkiller at once. You will go home that day if you feel well enough.
When you first feel your bowels want to act after the operation, take a painkiller. Wait an hour for it to work. Run a hot bath before you pass a motion, pass it, then get into the hot bath at once.
The bowel action will cause some bleeding. It will hurt, but the painkiller and an immediate hot bath should make this tolerable. The best way to keep your anus clean is to wash gently with water, but no soap. Gently pat your anus dry. Put a pad to absorb any oozing, then a pair of disposable underpants provided by the hospital.
Recovering at home
Before you leave hospital, check that you have absorbent pads and disposable underpants and the following:
| Purpose | Usual Dose | |
| Movicol | Keeps motions runny | 1 Sachet/day |
| Fybogel | If you prefer soft but formed motions | 2 sachets/day |
| Painkillers | Prevent or reduce pain | As prescribed |
| Anethaine Cream | Relieves stinging from wound | The volume of two peas |
Use Movicol and/or Fybogel to avoid constipation.
Make sure you have enough pain killers to last you through the night. You do not want to run out and not be able to get again.
If your anus burns after a motion, apply a little Anethaine gently to the wound with your finger. It may sting for a few seconds, then should stop the burning.
Bowel actions hurt most 3-5 days after the operation, then become easier.
For a few weeks after the operation, you will feel anal lumps. They are swollen folds of skin. The swelling is caused by the operation. The lumps of skin will shrink as the swelling subsides.
For the first month you will notice a yellow discharge from the anus. When your bowels act, expect some blood on the paper. The discharge and the bleeding will slowly improve but they may take three months to stop completely.
Back to work
How long you stay off work depends on how uncomfortable you are. Most people take one or two weeks off. Some return to work faster and others takes longer.
What to expect in the long run?
The operation removes the largest blood vessels from the anus, those which have expanded to form piles. It does not remove the normal blood vessels. Some may enlarge in future to form new piles. New piles are seldom big enough to need surgery. If they bleed, they may need to be shrunk by having rubber bands put around them.
After the operation your bowels should work without bleeding or discomfort. It is not a cosmetic operation, and it is not possible to get your anus to look “like a baby’s bottom”. After three months you may still feel a few folds of skin, but pain should not occur. Any bleeding should be rare and very minor. The operation should not affect your ability to control wind or your motions.