Hemorrhoidectomy in Draper, Utah

Hemorrhoidectomy

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Hemorrhoidectomy

Hemorrhoidectomy (Single-Pillar) — Patient Information & After-Care

What is it?
A single-pillar hemorrhoidectomy removes one symptomatic hemorrhoid column in the office using local anesthesia only. Dr. Hansen does not use cautery (no burning) to help reduce postoperative pain. The vessel is tied/secured and the incision is closed with absorbable stitches. You remain awake, lying on your side, and you can go home immediately—no escort or ride needed for most patients.
Who is a good candidate?
You may benefit if one main hemorrhoid causes bleeding, prolapse, pain/swelling, or hygiene problems despite fiber, stool softeners, creams, or banding. Your surgeon will confirm that a single-pillar approach fits your situation and review alternatives.

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Getting ready (before the procedure)• Bowel habit: Work toward soft, regular stools before your visit: start fiber and a stool softener 3–5 days prior; drink 6–8 glasses of water daily.• Medications: Tell us about blood thinners, diabetes meds, or allergies. Do not stop prescriptions unlessdirected.• Food & drink: Because there is no sedation, you may eat/drink normally unless told otherwise.• Hygiene/comfort: Shower the day of the procedure; consider a thin pad/liner for light spotting.• Transportation: Most patients may drive themselves home.
Day-of: what to expect1) Check-in & consent → 2) Side-lying position → 3) Local anesthetic to fully numb → 4) Excision without cautery → 5) Tie/secure vessel and close with absorbable sutures → 6) Optional pain add-ons: steroid and/or Exparel® (liposomal bupivacaine) for up to ~3 days of added relief → 7) Go home with written instructions. Typical total time in clinic: ~30–45 minutes.
After your procedure: Home care instructionsFollow the steps below exactly as written. If you have questions, call 801-523-6177.
1) Pain medicines (scheduled): Start taking 2 Tylenol (acetaminophen) and 3 Ibuprofen 4 times a day at meal times and before bed. Aleve can be used instead of ibuprofen, but it is a 2-times-a-day medication. These can be taken in addition to your prescription pain meds if you are not allergic and have no ulcers. Treat a prescription pill like a Tylenol. Safety: Don’t exceed 3,000 mg acetaminophen/24 h (count combo pills). Do not takeibuprofen and Aleve together. Avoid NSAIDs if advised by your doctor.
2) Stool softener while on pain meds: Take Colace (Docusate Sodium) twice a day until stools are soft while you are taking pain medication. If you are having loose stools, discontinue the stool softener. You may discontinue once you stop narcotic pain medication.
3) If no bowel movement by postoperative day 2: Start Miralax (polyethylene glycol), one tablespoon, 1–3 times daily until your bowels move. You may add milk of magnesia if still unable to move your bowels. Call the office for further instructions if still unable to move your bowels.
4) Meals, fluids, and fiber: Eat three meals per day as tolerated and drink plenty of water (at least 1 liter/day). Increase fiber slowly to 20–25 grams/day and/or take a fiber supplement such as Metamucil, Citrucel, or Benefiber (or generic) once or twice a day as directed.
5) When to call about urination, fever, or wounds: If you are unable to urinate after 8 hours or experience extreme difficulty with urination call the office. If you have redness in your wounds, purulence (pus), or experience a temperature > 101.0°F call the office.
6) What symptoms are common vs. concerning: Common: mild bleeding, drainage, swelling, burning, itching, pain with bowel movements. Use a dry gauze pad for drainage as needed. A Kotex pad or “liner” works very well until there is no drainage. Expect some minor bleeding or drainage ~10 days, occasionally longer. Call if you have excessive bleeding, greater than 1 pad per hour.
7) Activity, work, driving, sexual activity: You may be up and around the day after the surgery. You may return to work when you feel ready. You may drive a car when you are off prescription pain medicine. You may resume sexual activity at your comfort level.
8) Sitz baths & showering: Take a “sitz bath” in the morning, soaking the anorectal area in plain warm water, for 15–20 minutes, three to four times per day and as needed. Shower anytime.
When to call us (any time): 801-523-6177• Fever > 101.0°F, increasing redness, or foul/purulent drainage• Heavy bleeding (≥ 1 pad per hour or passing large clots)• Inability to urinate or severe, worsening pain not relieved by medicines/sitz baths• No bowel movement by day 3 despite the plan above
Follow-upA follow-up check is usually scheduled in 2–4 weeks, or sooner if you have concerns.Alternatives we may discussDietary optimization, fiber, topical therapies, office band ligation, infrared coagulation, or observation— depending on your symptoms and exam.
This handout reflects Dr. Hansen’s office technique and general guidance. It does not replace individualized medical advice. Your plan may be adjusted based on your medical history and exam.

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Why It Is Done

Hemorhoidectomy is appropriate when you have:
• Very large internal hemorrhoids.• Internal hemorrhoids that still cause symptoms after nonsurgical treatment.• Large external hemorrhoids that cause significant discomfort and make it difficult to keep the anal area clean.• Both internal and external hemorrhoids.• Had other treatments for hemorrhoids (such as rubber band ligation) that have failed.
How Well It WorksSurgery usually cures a hemorrhoid. But the long-term success of hemorrhoid surgery depends a lot on how well you are able to change your daily bowel habits to avoid constipation and straining. About 5 out of 100 people have hemorrhoids come back after surgery.
RisksPain, bleeding, and an inability to urinate (urinary retention) are the most common side effects of hemorrhoidectomy.
Other relatively rare risks include the following:
Early problems• Bleeding from the anal area.• Collection of blood in the surgical area (hematoma)• Inability to control the bowel or bladder (incontinence)• Infection of the surgical area-rare• Stool trapped in the anal canal (fecal impaction)
Late problems• Narrowing (stenosis) of the anal canal.• Recurrence of hemorrhoids.• An abnormal passage (fistula) that forms between the anal or rectal canal and another area.• Rectal prolapse, which happens when the rectal lining slips out of the anal opening

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