Hemorrhoids, commonly known as piles, are swollen and inflamed veins located around the anus or in the lower rectum. They can form internally, within the lining of the anus and lower rectum, or externally, beneath the skin surrounding the anal opening. For individuals experiencing severe or persistent symptoms, surgical intervention often becomes a necessary and effective treatment.
Understanding Recurrence After Surgery
While surgery removes existing hemorrhoids, it does not eliminate the underlying predisposition to their formation, meaning they can return. Studies indicate that the recurrence rate after surgery can range from approximately 5% to 56.5%, depending on the specific surgical method and the patient’s lifestyle adjustments.
Factors Contributing to Hemorrhoid Recurrence
Several factors contribute to the potential return of hemorrhoids following surgery. Chronic constipation or excessive straining during bowel movements contributes, as hard stools require more effort to pass, increasing pressure on rectal veins. Chronic diarrhea can also irritate the rectal area, making it more vulnerable.
A diet lacking sufficient fiber and inadequate hydration also contributes, as these habits lead to harder stools that are difficult to pass. Prolonged sitting, especially on the toilet, can increase pressure on the anal veins. Regularly lifting heavy objects elevates intra-abdominal pressure, stressing these vessels. Obesity places continuous pressure on the pelvic floor and rectal veins, increasing the risk of recurrence. Inadequate post-surgical care or a failure to adopt long-term lifestyle changes can also increase the risk of hemorrhoids returning.
Steps to Prevent Future Hemorrhoids
Preventing the recurrence of hemorrhoids after surgery primarily involves consistent lifestyle modifications that address the underlying causes. Increasing dietary fiber intake, aiming for 25 to 30 grams daily from fruits, vegetables, and whole grains, helps soften stools and promote regular bowel movements. If dietary intake is insufficient, fiber supplements can be considered.
Maintain adequate hydration by drinking plenty of water, typically 6 to 8 glasses a day, which helps keep stools soft. Avoiding straining during bowel movements prevents excessive pressure on rectal veins; this involves responding promptly to the urge to defecate and avoiding prolonged sitting on the toilet. Regular physical activity, such as walking, swimming, or cycling, promotes healthy bowel function, improves circulation, and helps maintain a healthy weight, reducing pressure on the anal area. Limiting prolonged sitting, especially for those with sedentary occupations, by taking frequent breaks to stand or move around, also contributes to prevention.
Addressing a Return of Hemorrhoids
Should hemorrhoids reappear after surgery, seeking prompt medical advice from a healthcare professional is important for diagnosis and treatment. A recurrence does not always necessitate repeat surgery, as various non-surgical options are often considered first. Initial approaches might include dietary adjustments, the use of topical creams, or warm sitz baths to alleviate symptoms.
Other non-surgical procedures include rubber band ligation, where small bands are placed around the base of the hemorrhoid to cut off its blood supply, causing it to shrink. Sclerotherapy involves injecting a chemical solution to shrink it, while infrared coagulation uses light or heat for a similar effect. Hemorrhoidal artery embolization or ligation may also block blood supply to affected veins. If conservative and minimally invasive methods prove ineffective or for severe cases, repeat surgery may be considered, with traditional hemorrhoidectomy generally offering lower recurrence rates despite a longer recovery period.