Hemorrhoid surgery is the surgical removal of hemorrhoids and excess tissue around the hemorrhoid. Hemorrhoids are swollen, stretched veins in the wall of the anus and rectum. Hemorrhoid surgery is important in the treatment of extensive or severe hemorrhoids. It is not generally used to treat mild to moderate hemorrhoids unless patients develop certain complications (e.g., persistent bleeding) or other treatments fail.

Hemorrhoid surgery usually requires an overnight hospital stay, but may be performed on an outpatient basis. Before the procedure, the patient is usually placed on a special diet to prepare the bowels. Laxatives and an enema may be used to clear the lower gastrointestinal (GI) tract prior to surgery. The procedure is performed under anesthesia and a device called an anoscope is used to view the hemorrhoid. During the surgery, the blood supply to the hemorrhoid is tied off and the hemorrhoid is removed, along with some surrounding tissue, if necessary. The surrounding lining may be left open or closed.

Pain and discomfort are common following hemorrhoid surgery and pain-relief medications are usually prescribed. After surgery, the rectal area is monitored for bleeding and laxatives are used to ease defecation. Fluid intake is also monitored. Any increased rectal bleeding, pus drainage, fever, constipation or rectal spasms need to be reported to a physician. It is important to prevent constipation following surgery. Therefore, patients may be encouraged to exercise, drink plenty of fluids and eat a high-fiber diet.

Hemorrhoid surgery is the most effective treatment for hemorrhoids. However, it does pose potential risks. Urinary retention, urinary tract infections, fecal impaction and bleeding are the most common complications of the procedure. Alternatives to hemorrhoid surgery include many minimally invasive techniques, especially rubber band ligation and coagulation (e.g., infrared coagulation, electrocoagulation). New techniques for treating hemorrhoids are also being developed.