A haemorrhoidectomy is a surgical procedure to remove swollen, painful haemorrhoids that have not settled with simpler treatments. It is not usually the first option doctors consider, but for some people it offers the most reliable way to find lasting relief. Haemorrhoids are common, and there is no need to feel embarrassed about asking for help.
This article looks at when surgery becomes the right choice, what the procedure involves, and what recovery generally looks like for Australian patients. Speaking with your GP is always a sensible first step if you are unsure what your symptoms mean. If you are experiencing heavy rectal bleeding or severe pain, do not wait for a referral, call 000 or go to your nearest emergency department.
What Are Haemorrhoids, and Why Might Surgery Be Needed?
Haemorrhoids, sometimes called piles, are swollen blood vessels in and around the anus and lower rectum. They are extremely common and affect people of all ages, though they become more likely as we get older.
Symptoms can include itching, discomfort and bleeding, particularly during bowel movements. You can read more about the condition on healthdirect’s guide to haemorrhoids.
Most cases settle down with simple changes at home or treatment from a GP. But when haemorrhoids are large, keep coming back, or do not respond to other treatments, a haemorrhoidectomy may be recommended.
Risk factors include pregnancy, constipation, ageing, and jobs that involve long periods of sitting or heavy lifting. Knowing these factors will not necessarily prevent haemorrhoids, but it helps explain why they are so common.
Non-Surgical Treatments Usually Tried First
Surgery is rarely the first step, and many people find real improvement with simpler measures. Most GPs will suggest less invasive approaches before considering a surgical referral.
- Increasing dietary fibre and fluid intake to soften stools
- Topical creams or ointments to ease itching and discomfort
- Warm baths, sometimes called sitz baths, a few times a day
- Minor in-clinic procedures, such as banding, for some internal haemorrhoids
- Avoiding straining and long periods sitting on the toilet
- Reviewing toilet habits and posture with guidance from your GP
General guidance on these approaches is available through resources such as the Better Health Channel.
When Does a Haemorrhoidectomy Become the Recommended Option?
If non-surgical treatments have not worked, or if haemorrhoids are severe, your GP may suggest a referral to a specialist colorectal surgeon.
Surgery is typically considered for large external haemorrhoids, haemorrhoids that prolapse (come out of the anus), or ongoing bleeding despite treatment.
Choosing a RACS-accredited surgeon means you are seeing someone who has met strict national training standards. Your GP can guide this referral, and you are always free to seek a second opinion.
Some people also consider surgery because other treatments only give temporary relief and they want a more lasting solution. This is a personal decision, and it is worth discussing openly with your specialist surgeon.
How Is the Procedure Performed?
A haemorrhoidectomy is generally carried out as day surgery, meaning many patients go home the same day, though some stay overnight depending on their circumstances. The exact technique used depends on the size, number and position of the haemorrhoids.
The surgeon removes the affected tissue, usually under general or regional anaesthesia. Your anaesthetist will discuss the options and any risks with you beforehand.
Before the operation, most patients attend a pre-admission clinic, where their health and medications are reviewed. This is also when informed consent is discussed, so you understand what the surgery involves before agreeing to it.
Recovery Timeline and Managing Discomfort
Recovery after a haemorrhoidectomy varies, but most people need one to two weeks off work, sometimes longer for physically demanding jobs.
Discomfort in the days after surgery is common and expected. Pain relief, stool softeners and warm baths are often recommended to support healing.
Your surgical team will give you specific guidance for post-operative recovery, including when to resume normal activities and which symptoms should prompt a call to your surgeon or GP.
It is normal to feel more tired than usual in the first week or so. Gentle movement, such as short walks, can support healing, but always follow the instructions your surgeon gives you.
What Are the Risks?
As with any operation, a haemorrhoidectomy carries some risks, including bleeding, infection, temporary difficulty controlling bowel movements, and narrowing of the anal canal.
These complications are not common, but your surgeon will discuss your individual risk factors during your consultation. No surgery comes with a guaranteed outcome, and it is important to raise any concerns before giving consent. Serious complications are uncommon, and most people recover well, but understanding the possibilities beforehand helps you make an informed decision.
Medicare, Private Health Insurance and Choosing Your Pathway
In the public system, a haemorrhoidectomy is generally treated as elective surgery, meaning you are placed on a public hospital waitlist once your specialist referral is assessed. How long you wait can depend on the hospital, the urgency of your case, and local demand.
Medicare provides rebates towards some costs of specialist consultations and hospital treatment, while private health insurance can shorten waiting times. Waiting periods and out-of-pocket costs vary between policies, and checking your cover through privatehealth.gov.au can help you understand what is included.
Before agreeing to surgery, your surgeon’s rooms should provide informed financial consent, a clear written outline of expected costs, so there are no surprises later.
Conclusion
Deciding on a haemorrhoidectomy is a personal decision best made with guidance from your GP and a specialist surgeon. Most people who reach this point have already tried simpler treatments, and surgery can offer a chance at longer-term relief.
If your haemorrhoids are affecting your daily life, start by asking your GP about a referral, and take a little time to prepare your questions beforehand. You can also use surgery.com.au to compare RACS-accredited surgeons across major Australian cities and take the next step toward treatment.
FAQs
1. Is a haemorrhoidectomy painful?
Some discomfort after surgery is normal and expected, though pain relief and simple aftercare usually help manage it. Everyone recovers a little differently, so your surgical team will tailor advice to your situation. It is worth discussing pain management with your surgeon before the procedure, so you know what to expect.
2. How long does recovery from a haemorrhoidectomy take?
Many people need one to two weeks off work, though this depends on the extent of surgery and the physical demands of your job. Full healing can take a few weeks longer. Your surgeon will give you a timeline based on your individual procedure.
3. Will Medicare cover my haemorrhoidectomy?
Medicare can provide rebates towards eligible specialist and hospital costs, but the amount depends on your circumstances and whether you are treated publicly or privately. Private health insurance may also apply, subject to waiting periods and policy inclusions. It is worth checking with Medicare and your health fund before your procedure.
4. Can haemorrhoids come back after surgery?
While a haemorrhoidectomy is generally considered an effective long-term treatment, no surgery can guarantee haemorrhoids will not return. Lifestyle factors, such as diet and toilet habits, can play a role. Your GP can advise on ongoing prevention.
5. Do I need a referral to see a colorectal surgeon?
Yes, in Australia you generally need a referral from your GP to see a specialist colorectal surgeon, whether you are treated publicly or privately. This referral also affects your Medicare rebate eligibility. Your GP can talk you through the process and what happens next.