Hemorrhoid healing time following treatment for hemorrhoids vary according to the type of procedure used. As a rule, hemorrhoids will heal more slowly with medical treatment, but you will not need to take time off for surgery. More invasive surgery such as hemorrhoidectomy will take longer to heal.
Do hemorrhoids heal on their own?
Some hemorrhoids will heal without any treatment. This usually happens if they are less severe, such as grade 1. However, you may want to try ointments or pain relief for the symptoms, or surgery to cure the hemorrhoids.
Painkillers will relieve painful hemorrhoids and may also help to dampen down inflammation, particularly if they are anti-inflammatory such as aspirin or ibuprofen.
Ointments and suppositories
These can be applied to the skin or into the rectum and will be absorbed into the haemorrhoid and surrounding blood vessels.
Doxium® (calcium dobesilate) can strength your blood vessels, reduce the thickness of your blood and promote healing of hemorrhoids. In one study, 86% of patients found their symptoms had improved two weeks later in a sample of 29 patients. It was first made in 1972 by Johnson & Johnson.
One study compared the healing times between the open Milligan Morgan and closed Ferguson techniques. The amount of time patients spent in hospital after the operation and the time taken off work were similar in both groups. The wound healing time was longer with the Milligan Morgan procedure but there were fewer complications and pain scores were comparable. It has also been suggested that the wound is more likely to come apart and get infected with the Ferguson technique, but this varies between studies. It is unclear whether the Ferguson technique has a lower rate of anal incontinence at present.
A relatively new technique called ‘sutureless’ hemorrhoidectomy has also been developed. This uses an electrothermal machine (Ligasure®) to seal off blood vessels rather than stitching them, and cuts down on blood loss, urinary retention and narrowing of the anal canal, shortening the recovery time following surgery. Another method known as the Harmonic Scalpel, which uses ultrasound, can also reduce operative bleeding and pain after surgery for hemorrhoids.
Stapling (designed by Longo) is a good alternative to conventional hemorrhoidectomy for second and some third degree hemorrhoids. If you opt for stapling, your healing time and hospital stay is likely to be shorter and you will return to work more quickly. However, it may not be suitable for more advanced hemorrhoids and your hemorrhoids are more likely to come back.
In a clinical trial of patients with acquired immunodeficiency syndrome, 22 patients were given sclerotherapy for grade 2 to 4 hemorrhoids. The treatment was successful in all patients and no hemorrhoidectomies were performed subsequently. Three patients went back for further sclerotherapy treatment. Complications were infrequent and wounds were much smaller than conventional surgery, suggesting this therapy may benefit those with a weakened immune system.
Laser therapy generally has shorter healing times than hemorrhoidectomy. In one study of patients with grade 2 to 4 hemorrhoids, the total complication rate was 3.51%, most patients did not need to stay in hospital overnight, and bleeding/abcess rates were 0.5%. However, it may take some time for surgeons to learn this relatively new technique.
HALO (hemorrhoid arterial ligation operations)
In a study comparing hemorrhoid arterial ligation operations with traditional hemorrhoidectomy, pain scores and feelings of well-being were lower in the HALO group. After one year, the haemorrhoid grade had decreased in both groups, but soiling had only decreased in the hemorrhoidectomy group.
Helping the healing process
Taking vitamin supplements may help to heal wounds if you are deficient in them. Another substance that has been tried is aloe vera, although the studies are not scientifically rigorous enough to produce any firm results.
GTN (glyceryl trinitrate) may also help the healing process by relaxing muscle spasms, increasing blood supply to wounds and reducing wound secretions. One study of 203 patients treated with hemorrhoidectomy found that the group given 0.4% GTN ointment for six weeks after surgery had lower pain scores in the first week, fewer secretions and shorter bleeding times. They also experienced less itching and were able to return to daily activities sooner. Some patients stopped taking the treatment due to side effects, mainly headache and pain around the hemorrhoid area.
There is some evidence that having a hemorrhoidectomy just after (two to four days) you have given birth is a good idea, as the hormones in pregnancy lead to faster healing times. Hemorrhoids are common in pregnancy (see the section “Causes of hemorrhoids”).