A�hemorrhoid�can be described as masses or clumps of tissue within the anal canal that contain blood vessels and the surrounding, supporting tissue made up of muscle and elastic fibers. The anal canal is�the last four centimeters through which stool passes as it goes from the rectum to the outside.

If your hemorrhoid symptoms do not get better with other therapies, it may be necessary to have a hemorrhoidectomy to remove them. Although hemorrhoids are present in everyone, it is only when the hemorrhoidal cushions enlarge that hemorrhoids can cause problems and be considered abnormal or a disease.

Symptoms

Many anorectal problems, including fissures, fistulae, abscesses, or irritation and itching (pruritus ani), have similar symptoms and are incorrectly referred to as hemorrhoids.

Hemorrhoids usually are not dangerous or life threatening. In most cases, hemorrhoidal symptoms will go away within a few days.

Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding hemorrhoid.

Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a�thrombosed external hemorrhoid.

In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching.

Diagnosis

A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool occurs. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer.

The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.

Closer evaluation of the rectum for hemorrhoids requires an exam with an anoscope, a hollow, lighted tube useful for viewing internal hemorrhoids, or a proctoscope, useful for more completely examining the entire rectum.

To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and lower colon (sigmoid) with sigmoidoscopy or the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum.

This procedure is done under either spinal anesthesia or general anesthesia. The procedure takes approximately 1 - 2 hours. Stapled hemorrhoidectomy is the newest surgical technique for treating hemorrhoids and it has rapidly become the treatment of choice for third-degree hemorrhoids. Stapled hemorrhoidectomy is a misnomer since the surgery does not remove the hemorrhoids but, rather, the abnormally lax and expanded hemorrhoidal supporting tissue that has allowed the hemorrhoids to prolapse downward.

A circular, hollow tube is inserted into the anal canal. Through this tube, a suture� is placed, circumferentially within the anal canal above the internal hemorrhoids. The ends of the suture are brought out of the anus through the hollow tube. The stapler (a disposable instrument with a circular stapling device at the end) is placed through the first hollow tube and the ends of the suture are pulled. Pulling the suture pulls the expanded hemorrhoidal supporting tissue into the jaws of the stapler. The hemorrhoidal cushions are pulled back up into their normal position within the anal canal. The stapler then is fired. When it fires, the stapler cuts off the circumferential ring of expanded hemorrhoidal tissue trapped within the stapler and at the same time staples together the upper and lower edges of the cut tissue.

Stapled hemorrhoidectomy, although it can be used to treat second degree hemorrhoids, usually is reserved for higher grades of hemorrhoids - third and fourth degree. If in addition to internal hemorrhoids there are small external hemorrhoids that are causing a problem, the external hemorrhoids may become less problematic after the stapled hemorrhoidectomy.� Another alternative is to do a stapled hemorrhoidectomy and a simple excision of the external hemorrhoids. If the external hemorrhoids are large, a standard surgical hemorrhoidectomy may need to be done to remove both the internal and external hemorrhoids.

Postoperative

Keep the area clean and take bath multiple times. The use of stool softeners is recommended and instructions will be provided by the hospital. In case of pain you will be given oral pain medications, there would be suitable ointments applied to the area. One should avoid lifting of weights totally for atleast 2 - 3 months

Complete recovery will take 2-3 weeks. If your surgery is successful, you should have relief from your symptoms. If your hemorrhoids come back, let your doctor know.

The other general procedures are:

• Abdominal or Thoracic Aortic Aneurysm Surgery
  
• Abdominoplasty
  
• Carpal Tunnel Release Operation.� etc

Few Major Hospitals for Hemorrhoidectomy are:

• Wockhardt Hospitals
  
• Apollo Hospitals
  
• Max Healthcare
  
• Piyavate Hospital
  
• Florence Nightingale Hospital
  

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