Hemorrhoid Treatment Surgery Experience

What are hemorrhoids – and when is it called a hemorrhoidal disease?

Hemorrhoids are physiological vascular cushions in the rectum. Together with the sphincter muscle, they ensure the fine sealing of the anal canal. They are well supplied with blood, elastic, and perform an important function in continence. Hemorrhoidal disease is only diagnosed when these vascular cushions are enlarged, displaced, or permanently overloaded and thereby cause symptoms. Typical complaints include itching, burning, oozing, pain, or bleeding during bowel movements. The crucial factor is therefore the dysfunction of the hemorrhoids, not their mere existence.

Why do hemorrhoidal complaints occur at all?

Hemorrhoidal complaints usually develop gradually and are the result of repeated stresses in the rectal area. Central to this is a chronic pressure situation on the vascular cushions. This can be caused by frequent straining, unfavorable stool consistency, or prolonged stool retention in the rectum. Over time, the vascular cushions lose their elasticity, expand, and can no longer reliably fulfill their sealing function. The complaints therefore do not arise suddenly but develop over a longer period through the interaction of several factors.

What role do pressure, stool regulation, and lifestyle play?

The development of hemorrhoidal disease is closely related to mechanical and functional stresses. Three factors are central:

Pressure: Increased pressure in the abdominal and rectal area, for example due to strong straining, prolonged sitting on the toilet, overweight, or pregnancy, permanently stresses the vascular cushions.

Stool regulation: Hard, dry stools increase resistance during bowel movements and force stronger straining. But very frequent or mushy stool can also irritate the rectum, as it creates a moist, stressful environment.

Lifestyle: Lack of exercise, low-fiber diet, irregular toilet habits, and stress-related digestive disorders negatively affect stool quality and bowel movement. These factors do not act in isolation but reinforce each other.

In summary, hemorrhoidal complaints arise where pressure load, unfavorable stool conditions, and lifestyle-related influences permanently coincide. Sustainable relief of the rectum therefore addresses not only individual symptoms but the overall functional situation.

What experiences do patients report after hemorrhoid surgery?

Experiences after hemorrhoid surgery vary greatly and cannot be reduced to a uniform course. Many patients report that they find the first few days after the procedure physically and mentally challenging. Commonly mentioned are pain in the anal area, especially during bowel movements, a feeling of pressure, and uncertainty during defecation. These symptoms mainly occur in the early healing phase and usually decrease significantly as the wound heals.

At the same time, many affected individuals retrospectively report a noticeable improvement in their quality of life once the acute healing phase is completed. Symptoms such as persistent moisture, bleeding, or recurring itching that existed before the operation often decrease significantly or even disappear completely. Patients therefore often describe the operation as worthwhile in hindsight, even if the short-term healing process was experienced as strenuous. It is important that expectations remain realistic. A hemorrhoid operation is not a "minor procedure" but a targeted measure that entails a genuine need for recovery.

Which factors influence the individual course of the operation?

The course after a hemorrhoid operation is determined by several factors that influence each other. This explains why experiences vary so much.

A central influencing factor is the chosen surgical method. Minimally invasive procedures generally involve less postoperative pain and shorter healing times than open surgical procedures. The severity of the hemorrhoidal condition also plays a role: extensive or higher-grade hemorrhoids often require larger interventions, which can prolong the healing process. Furthermore, individual factors have a significant impact. These include personal pain perception, general tissue regeneration, existing comorbidities, and bowel function. Stool regulation after the operation is particularly important. Hard stools, strong straining, or irregular bowel movements can additionally strain the rectum and delay the healing process.

Last but not least, aftercare is crucial. Careful anal hygiene, an adapted diet, sufficient fluid intake, and – if recommended – the supportive local application of medical products for mucous membrane care significantly contribute to reducing pain and promoting healing.

How painful is a hemorrhoid operation generally?

Many patients perceive a hemorrhoid operation as painful, especially in the first few days after the procedure. The anal area is very sensitive and rich in nerve endings, so even small wounds are clearly felt. The pain is caused less by the procedure itself – which is performed under anesthesia – and more by the subsequent wound healing, the contact of the wound with stool, and the necessary stretching during bowel movements. Typically, burning, pulling, or pressure-like pains occur, which are strongest during the first bowel movement after the operation and appear in the first few days.

How do the pain symptoms differ depending on the surgical method?

The intensity and duration of pain strongly depend on the chosen surgical method. Minimally invasive procedures, which injure less tissue, generally involve fewer postoperative complaints. In contrast, classic open procedures often cause stronger and longer-lasting pain because larger wound areas develop in the sensitive anal region. The location of the wounds also plays a role: procedures above the pain-sensitive zone are often perceived as less burdensome than those in the outer anal canal. Accordingly, patients report very different pain courses depending on the method.

How long do pain symptoms typically last after hemorrhoid surgery?

The duration of pain varies from person to person, but it often follows a typical course. In the first days after surgery, the symptoms are most pronounced. Within the first one to two weeks, the pain significantly decreases for most patients. Mild discomfort, especially during bowel movements, can persist for several weeks depending on the procedure. In uncomplicated healing, usually only minor or no pain remains after four to six weeks at the latest. Besides the surgical method, stool regulation is particularly crucial, as soft, well-formed stool puts significantly less strain on the rectum and positively influences the healing process.

How long does the healing take after a hemorrhoid operation?

The healing duration after hemorrhoid surgery varies from person to person and mainly depends on the surgical method, the extent of the procedure, and the individual regenerative capacity. In most cases, the healing process extends over several weeks. While smaller, minimally invasive procedures can be largely healed after a few days to two weeks, the body often needs four to six weeks after classic surgical methods to fully close the wounds and stabilize the tissue.

How does healing progress in the first weeks after surgery?

The healing process can roughly be divided into different phases. In the first week, pain, swelling, and increased sensitivity are predominant. Since bowel movements are often perceived as uncomfortable during this phase, consistent stool regulation is particularly important. In the second and third weeks, the wounds begin to granulate and visibly close. The pain and pressure sensation gradually decrease, bowel movements normalize, and many patients regain confidence in everyday life.

From the third to fourth week, a significant functional improvement is usually noticeable. Residual complaints may still occur, especially with prolonged strain or unfavorable stool consistency. However, they are generally milder. The mucosa remains sensitive during this phase and still requires protection.

When is the healing process complete?

The healing process is considered complete when the wounds are fully healed, no relevant pain remains, and bowel movements are possible without significant discomfort. This is usually the case after four to six weeks in uncomplicated courses. However, it is important to distinguish between visible wound healing and functional stability. Even after formal completion of healing, it may be advisable to continue gentle stool regulation, an adapted diet, and good anal care to prevent relapses or renewed irritation.

What complications can occur after a hemorrhoid operation?

Even though hemorrhoid surgeries are routinely performed today, it remains a surgical procedure in a very sensitive area. Accordingly, postoperative complications can occur, although they are generally rare. Possible complications include postoperative bleeding, wound healing disorders, infections, more severe pain than expected, or functional problems during bowel movements. In very rare cases, scarred changes or impairment of sphincter function can also occur.

Many of these complications are closely related to local wound healing, stool consistency, and mechanical stress on the rectum during the early healing phase. Consistent aftercare significantly reduces the risk.

How common are postoperative bleeding, infections, or scar problems?

Postoperative bleeding is among the more common complications, which can usually be well controlled. They mainly occur within the first 24 to 48 hours after surgery and typically present as bright red blood in the stool or on toilet paper. In most cases, these bleedings are minor and self-limiting.

Wound infections are generally rare because the anal area is well supplied with blood. When they occur, they usually manifest as increasing pain, redness, swelling, or fever. Scar problems such as a scarred narrowing of the anal canal are also rare and mainly occur after extensive or repeated procedures. Functional disorders, such as temporary fecal incontinence, are very rare and usually reversible.

Overall, the majority of patients experience a complication-free course, especially with good aftercare and stable stool regulation.

When should complaints after the surgery be medically evaluated?

Not every complaint after hemorrhoid surgery is automatically a warning sign. Pain, a feeling of tension, or slight bleeding can be normal in the early healing phase. However, medical evaluation is advisable or necessary if symptoms increase instead of decrease or if new symptoms appear.

These include persistent or heavy bleeding, increasing pain despite pain therapy, fever, purulent discharge, significant swelling, as well as problems holding stool or gas. If no bowel movement is possible for several days or only occurs with severe pain, this should be medically evaluated. As a general rule: in case of uncertainty, early consultation with the treating physician is recommended to detect and treat complications in time.

What surgical methods are there for hemorrhoids?

Various procedures are available for the surgical treatment of hemorrhoids, differing in technique, invasiveness, and strain on the rectum. Basically, these methods can be divided into minimally invasive procedures and classic surgical interventions.

Minimally invasive methods include rubber band ligation, sclerotherapy (obliteration), and the HAL-RAR method. They aim to reduce the blood flow to the hemorrhoids or specifically regress them without causing large wounds. These procedures are mostly outpatient and involve comparatively low strain.

Surgical procedures include the stapler hemorrhoidectomy (also called the Longo method) and the classic hemorrhoidectomy according to Milligan-Morgan. In these, excess or altered tissue is surgically removed. These interventions are more invasive, usually performed inpatient, and require a longer healing period. However, they offer a more sustainable solution for advanced cases.

Which procedures are suitable for which stages of hemorrhoids?

The choice of surgical method primarily depends on the stage of the hemorrhoidal disease and the individual symptom profile.

For Grade I and II hemorrhoids that still retract or only slightly prolapse, minimally invasive procedures such as sclerotherapy or rubber band ligation are often applied. These methods are gentle, effective, and do not require major interventions.

For Grade II to Grade III, the HAL-RAR method can be useful. This method specifically reduces the blood flow to the hemorrhoids and stabilizes the tissue without completely removing it. For more pronounced Grade III hemorrhoids that no longer retract on their own, the stapler method is often used.

Grade IV hemorrhoids, where the vascular cushions have permanently prolapsed, usually require a classic hemorrhoidectomy, as this is the only way to permanently remove the excess tissue.

Which hemorrhoid surgery is considered the "best" – and why is there no general answer?

There is no "best" hemorrhoid surgery because each method has different advantages and disadvantages and is not suitable for every initial situation. What matters is not the method itself but that it fits the individual condition.

Factors such as the hemorrhoid stage, severity of symptoms, previous treatments, personal pain sensitivity, comorbidities, and patient expectations play a central role. For example, a minimally invasive method may be optimal in early stages, while it can lead to relapses in advanced cases. Conversely, a radical operation is permanently effective but involves greater strain and a longer healing phase.

From a medical perspective, the "best" hemorrhoid surgery is therefore one that is sufficiently effective, relatively gentle, and stable in the long term. The decision should always be made individually and in close consultation with the treating physician.

In which cases is a conservative treatment no longer sufficient?

Conservative treatment reaches its limits when hemorrhoidal symptoms persist over a longer period despite consistent implementation or even worsen. Ointments, suppositories, stool-regulating measures, and lifestyle adjustments aim to relieve symptoms and reduce functional strain. However, they cannot reverse structural changes or a permanent enlargement of the hemorrhoidal cushions.

If symptoms such as bleeding, pain, moisture, or a foreign body sensation persist or only improve briefly despite adequate conservative therapy, this indicates that the anatomical change is already too advanced. Frequent relapses after initially successful conservative treatment also suggest that surgical therapy should be considered.

For which hemorrhoid grades is surgery recommended?

Surgical treatment is generally recommended from hemorrhoid grade III onwards. At this stage, the hemorrhoidal cushions prolapse during bowel movements and do not retract on their own. Conservative measures often only inadequately control symptoms at this stage.

For grade IV, when the hemorrhoids are permanently prolapsed and can no longer be pushed back, surgery is usually considered a necessary treatment option. In these cases, there is a pronounced structural change that can no longer be functionally influenced.

For grades I and II, surgery is not primarily recommended. However, it can be considered if repeated conservative or minimally invasive measures have been unsuccessful and the symptoms significantly impair quality of life.

Which symptoms clearly indicate surgical therapy?

Certain symptoms may indicate that surgical therapy is sensible or necessary. These mainly include persistent or recurring heavy bleeding that can lead to iron deficiency or anemia. Also, constant pain, pronounced pressure or foreign body sensation, as well as continuous moisture or mucus discharge, can indicate advanced disease.

Another clear sign is the persistent prolapse of hemorrhoids, especially if it can no longer be manually pushed back or recurs immediately. Additionally, complications such as anal thromboses, mucosal inflammations, or repeated inflammatory reactions in the rectum can strengthen the indication for surgery.

The overall situation is always decisive: Not a single symptom, but the combination of symptom intensity, duration, therapy resistance, and functional impairment determines whether surgery is medically appropriate.

What is the risk of recurrence after a hemorrhoid operation?

The risk of recurrence after hemorrhoid surgery is generally moderate but varies significantly depending on the surgical procedure, initial findings, and the patient's long-term behavior. The surgery removes or reduces the altered hemorrhoidal cushions, but the functional causes that led to the symptoms are not automatically eliminated.

If stress factors such as chronic straining, unfavorable stool consistency, or persistently increased pressure in the rectum remain, hemorrhoids can reoccur in the long term. Clinical practice shows that relapses tend to occur years after the procedure. They rarely indicate "surgical failure" but rather result from ongoing functional stresses.

How do recurrence rates differ depending on the surgical method?

Depending on the surgical method, recurrence rates differ significantly because the procedures affect the anatomy and function of the rectum to varying degrees.

Minimally invasive procedures such as rubber band ligation or sclerotherapy have the highest relapse rates because the hemorrhoids are not completely removed but only reduced in size. These procedures are mainly suitable for early stages but are more prone to recurring symptoms in the long term.

Stapler hemorrhoidopexy (Longo method) causes less postoperative pain compared to the classic operation but is associated with a slightly higher risk of recurrence because the hemorrhoidal cushions are not completely removed.

Procedures like HAL-RAR (doppler-guided ligation) have moderate recurrence rates and combine functional preservation with relatively good long-term stability.

The lowest recurrence rates are usually observed after a classic hemorrhoidectomy (for example, according to Milligan-Morgan). This method is more invasive, associated with a longer healing phase, and is considered the most permanent solution for advanced stages.

Which factors reduce the risk of recurring hemorrhoids?

The most important factor in reducing the risk of recurrence lies not in the surgery itself but in the time afterward. Stable stool regulation is crucial because it permanently reduces mechanical pressure on the rectum. The goal is to achieve regularly formed, soft stool that can be passed without straining.

A fiber-rich and well-tolerated diet, adequate fluid intake, and regular exercise support bowel function in the long term. Equally relevant are avoiding prolonged sitting on the toilet and consciously responding to the natural urge to defecate.

Consistent aftercare is also important: this includes medical check-ups, adapted local mucosal care, and, if necessary, the supportive use of suitable medical products for regeneration and soothing of the rectum.

In summary, it can be said: Hemorrhoid surgery can effectively relieve symptoms, but the risk of recurrence depends on the interplay of the surgical method and long-term functional relief of the rectum.

How does a hemorrhoid operation affect everyday life?

Hemorrhoid surgery temporarily affects daily life, especially in the first days and weeks after the procedure. Immediately after surgery, rest, wound healing, and as irritation-free bowel movements as possible are the focus. Many patients experience a feeling of tension, pain when sitting, or uncertainties during bowel movements in this phase. This can initially restrict the daily routine.

However, with progressing healing, resilience continuously increases. Everyday activities can be gradually resumed, with a conscious approach to one's own body remaining important. The goal is to avoid mechanically overloading the rectum again and to give the tissue sufficient time to regenerate.

When can one return to work after surgery?

The timing of the return to work depends on several factors, including the surgical method, individual healing progress, and the type of professional activity.

For sedentary or light activities (e.g., office work), a return to the workplace is often possible after about one to two weeks, provided the pain is well controlled and no complications occur.

In physically demanding jobs involving heavy lifting, prolonged standing, or high physical activity, a longer downtime may be necessary. Often, three to six weeks are recommended here to avoid jeopardizing wound healing.

Regardless of the activity, returning to work should be gradual and based on personal tolerance to stress. Medical consultation is especially advisable in case of persistent complaints.

Which stresses should be avoided after surgery?

In the early healing phase, stresses that increase pressure in the rectum or impair wound healing should be avoided. These mainly include strong straining during bowel movements, prolonged sitting—especially on the toilet—and heavy lifting.

Intensive physical activities that heavily strain the pelvic floor or abdominal pressure should also be paused initially. Instead, light exercise and short walks are advisable, as they promote blood circulation without stressing the rectum.

Another important point is the avoidance of irritants. These include unfavorable stool consistency, irregular bowel movements, and inadequate local care. An adapted diet, sufficient fluid intake, and conscious daily routines help to relieve the rectum and positively influence the healing process.

Why is follow-up care after a hemorrhoid operation crucial?

Aftercare is a central factor for treatment success following hemorrhoid surgery. While the surgical procedure removes or corrects the altered vascular cushions, it is crucial in the subsequent phase how well the rectum heals and whether complications or relapses occur.

The rectum is a particularly sensitive area because it is exposed daily to mechanical stress, moisture, and microbial influences. Without targeted aftercare, even correctly performed surgeries can lose their effectiveness due to disturbed wound healing, renewed irritation, or unfavorable stool conditions. The goal of aftercare is therefore to support the regeneration of the mucous membrane, minimize stress, and permanently reduce the functional causes of hemorrhoidal disease.

Which measures support the healing of the rectum?

The healing of the rectum is based on the interplay of several measures. A central role is played by mechanical relief: the less pressure, friction, and tensile forces affect the surgical area, the smoother the wound healing proceeds.

In addition, an irritation-free environment is crucial. This includes a stable intestinal milieu, an adapted diet, and avoiding factors that could dry out or irritate the mucous membrane. Regular medical check-ups are also part of aftercare to assess the healing process and intervene early if necessary.

Aftercare is therefore not a passive process but an active contribution by patients to long-term symptom freedom.

What role do stool regulation, hygiene, and local mucous membrane care play?

Stool regulation is the most important functional factor in aftercare. Soft, well-formed stool reduces straining pressure, shortens evacuation time, and prevents mechanical overload of fresh wound surfaces. A fiber-rich diet, adequate fluid intake, and if necessary, the temporary use of stool softeners support this goal.

Adjusted hygiene protects the wound from additional irritation. Gentle cleaning with lukewarm water without aggressive soaps or wet wipes is recommended. Excessive or too frequent cleaning can dry out the mucous membrane and delay the healing process.

Local mucous membrane care complements these measures. It serves to keep the mucous membrane moist, reduce friction, and support natural regeneration. This support is especially relevant in the rectum, where healing occurs under functional stress.

When and how can CANNEFF® SUP Suppositories be used supportively?

CANNEFF® SUP Suppositories can be used supportively as part of aftercare if medically recommended or deemed appropriate. They are intended as a medical device for the treatment of conditions in the anal canal after colorectal procedures, for internal and external hemorrhoids, as well as for inflammatory or irritation-related mucous membrane conditions.

The combination of CBD and hyaluronic acid aims to address several aspects of aftercare simultaneously.

Hyaluronic acid supports moisture retention and promotes the regeneration of the mucous membrane, while CBD has anti-inflammatory and soothing properties. Through local application, the active ingredients act directly at the site of stress.

CANNEFF® SUP Suppositories do not replace medical follow-up care or fundamental measures such as stool regulation or hygiene. However, they can contribute within a holistic aftercare concept to protect the mucous membrane, reduce irritation, and positively influence the healing process.

Are there effective alternatives to hemorrhoid surgery?

Yes, there are effective alternatives to hemorrhoid surgery, but not in every stage and for every manifestation of symptoms. Conservative and minimally invasive measures can particularly provide significant relief in the early stages of hemorrhoidal disease and delay or even make surgery unnecessary. The goal of these approaches is to reduce symptoms, relieve the mucous membrane, and influence the functional causes of the complaints without surgically intervening in the anatomy.

A realistic assessment is important: conservative measures cannot "remove" hemorrhoids; they act in a regulatory, relieving, and stabilizing manner. In advanced stages with permanently prolapsed hemorrhoids, they generally do not replace surgery.

When are conservative measures appropriate?

Conservative measures are especially useful for hemorrhoids of grades I and II as well as for mild to moderate complaints without permanent prolapse. They are also used when patients want to avoid surgery or when functional factors should first be optimized before a surgical intervention.

Typical situations where conservative approaches are indicated include recurring symptoms such as itching, burning, a feeling of pressure, or slight bleeding, provided there are no severe structural changes. Conservative elements also play an important role after minimally invasive procedures or surgical measures to prevent relapses and stabilize the mucous membrane.

What role do nutrition, exercise, and local medical products play?

Nutrition forms the central foundation of any conservative treatment. A fiber-rich and well-tolerated diet promotes a soft and consistent stool texture and reduces straining pressure in the rectum. Combined with adequate fluid intake, it significantly contributes to relieving the hemorrhoidal cushions.

Exercise supports this process by promoting bowel motility and reducing venous congestion in the pelvic area. Regular physical activity lowers the risk of chronic constipation and thus indirectly counteracts hemorrhoidal complaints.

Local medical products specifically complement these measures. They serve to soothe, moisturize, and regenerate the mucous membrane in the anal area. Products like CANNEFF® SUP suppositories with CBD and hyaluronic acid can be used supportively to relieve irritation, protect the mucous membrane, and promote healing in inflammatory or stress-related complaints.

In summary, conservative measures are an effective alternative to hemorrhoid surgery when applied early, consistently, and in the right context. Their greatest benefit lies in the combination of functional relief, lifestyle adjustment, and targeted local support.

How can one prevent hemorrhoids in the long term?

Long-term prevention of hemorrhoids does not focus on individual symptoms but on the conditions that lead to hemorrhoidal complaints. The goal is to permanently relieve the rectum and avoid recurring pressure and irritation situations. For this, a stable daily routine with regular bowel movements, a well-tolerated diet, and a conscious approach to stressful habits is crucial.

In this context, prevention does not mean short-term measures but the establishment of functionally favorable routines. These include a regular toilet rhythm without strong straining, sufficient exercise, and avoiding prolonged sitting, especially on the toilet. The earlier these factors are considered, the lower the risk that functional burdens in the rectum will become entrenched.

What is the significance of bowel health and stool consistency?

A healthy gut flora is one of the central pillars of hemorrhoid prevention. It significantly determines how stool is formed, how long it remains in the bowel, and with what pressure it must be expelled. Stable bowel function promotes a uniformly shaped, soft stool consistency that mechanically protects the rectum.

If the stool is permanently too hard, the straining pressure during bowel movements increases. This overloads the vascular cushions in the rectum. Conversely, if the stool is very soft or occurs frequently, this can lead to irritation of the mucous membrane. Both increase the long-term risk of hemorrhoidal complaints. A healthy gut flora, adequate fluid intake, and an individually well-tolerated, fiber-rich diet help maintain this balance.

Bowel health therefore does not directly prevent disease but regulates by creating stable conditions under which the rectum is less susceptible to overload and irritation.

Why is prevention crucial for a lasting good result?

Prevention is so important because hemorrhoids usually do not arise suddenly but develop over a longer period. Even after successful conservative treatment or surgery, the underlying functional risk factors remain if they are not specifically addressed. Without preventive measures, relapses often occur.

A lasting good result is based on reducing burdensome factors such as straining, unfavorable stool consistency, or venous congestion in the long term. Prevention thus does not work spectacularly but sustainably: it stabilizes bowel function, protects the mucous membrane, and continuously relieves the vascular structures in the rectum.

In summary, prevention is not just an additional step but the foundation of every successful hemorrhoid treatment. It determines whether the symptoms are only temporarily alleviated or whether long-term symptom freedom can be achieved.

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