Dear patient, I am going to share my experience, and I ask you to please be empathetic, as my answer is only to try to help you. I am not a medical doctor. I am a fifty-three-year old educated female. Since I was a child I struggle with constipation and at the age of 12, due to the habit of straining I developed hemorrhoids. In my late twenties, early thirties I delivered my three children via Cesarian. During the pregnancies I did fine, but carrying three big babies may have worsen my condition.
Through the years ,however, every seven years or so I would have a crisis, usually after having constipation and straining; I would see a doctor who prescribed me some suppositories and ointment and I would be fine in a few days. But last year, I had a crisis and no medication would help. My doctor explained that as we age our body becomes less forgiving. The pain lasted for months, and nothing worked . I became practically impaired as I could not function well. I believe that lifting weight worsen my symptoms. We bought a house, and I would carry heavy bags of soil, plant pots taking care of the garden etc After months in pain (the pain would last for hours every time I had a bowel movement) I decided to see a surgeon and get rid of the problem. So I consulted four different rectal and colon specialist to hear their opinion and make a final decision. The digital examination and the anoscopy were beyond painful, almost unbearable. From the four specialists I visited only one told me not to have the hemorrhoidrectomy , when I asked him why he did not recommend surgery he said the recovery was too painful and I could manage the symptoms without having the procedure.
Nonetheless, I decided to go ahead and have it done with another doctor anyway. I was ready to end my suffering and I thought I was strong and healthy enough and I would take the pain because after that I would never have to withstand hemmorrhoids pain again in my life. I thought I would better do it while I am under sixty, because the risks would be less.I took time off from work and told my boss i would be back in ten days. Little did I know that it would take over three months until I felt a little better to go back.
I was referred to a surgeon who is renowned in Orlando and considered one of the best. He had over twenty years of experience. The surgery took thirty minutes, was outpatient,and apparently simple. I went home hours after the procedure (just to go back three days later because the pain was too much to take) I thought I would recover fast as I did after my C-sections( I was out and about in a week.) Unfortunately, that was not the case and after over five months after the surgery i still deal with pain daily every time I have a BM.
So I am glad when I hear someone say they will manage their symptoms with medication, diet and with a healthy life style. Because, I believe, that unless the person becomes anemic from bleeding too much ( I never bled too much, but I have a male friend who did and had to have the surgery)no one should have this surgery.
And I tell you why: I was never told the hemorrhoids could return ( and they did - three external ones bigger than the ones I had before the surgery); I was never told I ran the risk of having a hemorrhoidal thrombosis , and I had it too. I am very strong and not sensitive to pain, but the pain after the surgery is the most horrendous experience, especially during and after a bowel movement.Nothing, I mean nothing, not even the narcotics they gave me would help with the pain. The only time I had a little relief was when I was in the bathtub, or in the sitz bath. I also used a heating pad while laying down as the manufacture does not recommend sitting on it. I was taking 3 ibuprofens every four hours for months. The pain has decreased, but It still goes on for hours after a bowel movement. When I asked the doctor why I seem not to heal he answered I was 'unlucky', when I asked if the surgery helped me he said 'time will tell.'
About a month after the surgery, as I continued having pain, the surgeon said he would like for me to go back to the operating room again. He needed to put me under anesthesia to exam me as examining me without anesthesia would be too painful. He suspected I had a stricture. Stricture is the narrowing of the anal passage, it happens when the patient develops scar tissue. If his suspicion was confirmed he would have to break the tissue. This is one more complication of the surgery they never told me about. For the first time I was scared with the news, but I would submit myself to any procedure if it helped stop the pain. This time I researched online and found out that after the procedure to break the scar tissue I would have to introduce a device in my anus daily, more than once a day to avoid the narrowing again. I read that in some cases the anus closes completely which can be very dangerous. Thankfully, the surgeon did not find any stricture ad I was delivered from the torture of having to introduce something in my anus when I was already in so much pain.
I still believe the pain will subside eventually. I know people who took six months and even a year to heal completely.
After the surgery besides the excruciating pain I had to deal with fecal incontinence, as I am so fearful to have constipation again I am taking the medications and supplements the doctor prescribed: a stool softener (Colace or Ducosate) , mineral oil and Physillium Husk (fiber.) I could not leave the house fearing I would have in incident when i was out.
Now back to your question, I have used hydrocortisone suppositories throughout my life for short periods of time, during crises only. Lately, a doctor prescribed me Canasa, but it did not seem to help.
As I mentioned before, sitz baths, and baths help with the pain. At least when you're in the water it relieves the pain. I had to install one and it costed me over $4,000.00, but it sure helped me a lot. I was in and out of it day and night.
Avoid lifting weight, avoid sitting for a long time, do not use toilet paper use those wet wipes instead and make sure you wash your anus after a BM. Someone on this website put together a great list on what to do to manage hemorrhoids.
Generally it is all common sense stuff such as: drink plenty of water, exercise (walk, ride your bike, swim anything that makes you move), eat fiber (mom was right, eat your fruits and vegetables - papaya, prunes, figs, oranges, tangerines, grapefruits with the pulp, pears- these are all laxative fruits); eat your greens (lots of them - kale, collard green, swiss chard, salads, arugula, brussels sprouts etc. They work as a little brush cleaning your inside and protecting you from cancer, diverticulitis and other diseases. Broccoli, cabbage, beet root, butternut squash, pumpkins, beans,brown rice, lentil, garbanzo beans, okra, grainy whole wheat breads are also great. Constipation(hard feces) is the number one enemy of someone with hemorrhoids, avoid it at all cost. Constipation can be genetic or due to an unhealthy life style with a diet poor in fiber, no exercise or not enough water intake.
I hope this helps. I am thankful for this website, I wish I had found it before the surgery and I would not have had it done. In fact, I avoided any negative story because I was determined to have the surgery and did not want to be affected by any horror story. I thought I could handle anything and if it did not work for someone it did not mean i would not work for me.
I now have a big medical bill and three hemorrhoids bigger than the ones I had before. It was a traumatic experience, the most painful one and it is still not over.
I do not regret making the decision to have the surgery done because I truly believe I was doing what was best best for me. I did not know any better. I have heard stories of success of people who had less invasive procedures done such as laser and band. I believe every case is different. In my case, I believe I had three or more big incisions, because of the degree of my hemorrhoids. I do not know much about what was done. The doctor who performed my surgery, left the hospital on Monday and I could never find him again.
I hope this is helpful for you.
Blessings.