Pain After Hemorrhoidectomy: What to Do

charles coleman
Written by Charles Coleman, MD on May 9, 2022

In addition to addressing your symptoms, your doctor may recommend some conservative treatments to help you recover. Over-the-counter pain medications can help with the discomfort of your procedure, as can a sitz bath.

If stronger pain medications are needed, your doctor may prescribe stool softeners or laxatives. A diet rich in fiber and plenty of water can also be beneficial. When the pain has subsided, you can resume normal activities.

Topical GTN ointment

The use of topical GTN ointment for the pain after hemorrhoid surgery has been shown to reduce postoperative pain and complications. The ointment contains 0.2 percent Glyceryl trinitrate, a compound found in human sweat. It is safe to use after the procedure, and does not affect wound healing.

The study included a randomized, controlled trial in which patients were randomly allocated to the GTN or non-GTN groups. The patients in the GTN group were required to apply 0.2% GTN ointment to the anal canal three times a day with gloved fingers. It was required to continue this procedure for two weeks after surgery.

Another study used botulinum toxin, which induces anal sphincter relaxation, as an alternative to topical GTN ointment for hemorrhoidectomy. A study by Davies et al. involved 50 patients. The study used the Milligan and Morgan technique to administer the toxin. Control group patients received 0.4ml of saline. The patients experienced significant pain reduction on day six and seven.

Local thermal application

The use of local thermal application after hemorrhoidectomy may reduce pain and improve patient outcomes. In a recent study, Balta and colleagues divided a group of patients with high-grade hemorrhoid disease into two groups. One group received local thermal application after surgery while the other did not. After surgery, the postoperative pain scores in the treatment group were lower than those of the control group.

Another treatment for hemorrhoid pain is sitz baths. A sitz bath is a soothing treatment that promotes healing. It is most effective after the hemorrhoid has decreased in size. A hemorrhoid cream helps relieve pain and spurs healing. In addition, hemorrhoid spray may be used to relieve pain or in conjunction with heat and cold therapy.

Sclerotherapy

Using sclerotherapy for pain after hemorrheoidectomy is a conservative treatment for internal haemorrhoids. This injection is typically performed as an outpatient procedure. It works by hardening and scarring the tissue surrounding the haemorrhoid. After four to six weeks, the resulting scar will form. The process is similar to spider vein removal.

The doctor will first grade the hemorrhoid by grading it on a scale of one to four. Patients with a grade two hemorrhoid may consider sclerotherapy for pain after hemorrhoidectomy if the hemorrhoid is troublesome and requires constant straining. A grade three hemorrhoid may be manually pushed back into the anal canal. If the hemorrhoid has reached a grade four or higher, surgery will be required.

Patients who undergo sclerotherapy for pain after hemorrheoid surgery should not expect to experience any immediate symptoms after the procedure. However, they should know that this procedure requires some recovery time and may cause temporary fecal incontinence. Some patients may also experience small amounts of bleeding and discomfort. Depending on the severity of the hemorrhoid and the severity of the pain, they may experience discomfort or pain for a few days to a week.

NoTamp study

The NoTamp study of pain after hemorryhoidectomy aims to identify effective interventions for the treatment of postoperative pain. The study focuses on two common hemorrhoidectomy techniques, Park's submucosal and Milligan Morgan's open hemorrhoidectomy. Both procedures remove excessive hemorrhoidal tissue and leave an open wound afterward. The NoTamp study compares the pain of patients after Park's submucosal hemorrhoidectomy with that of the patients who undergo the traditional open procedure.

Participants in the NoTamp study are randomly assigned to one of two treatment groups, with a 1:1 ratio. The study's centralized web-based tool will randomly allocate patients to the different treatment groups. Patients are not informed of their assignment before the surgery. The study will last seven days for each randomized patient. The NoTamp study is designed to be a high-quality, reproducible trial and is geared towards the transferability of results to clinical practice.

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