Pain after open hemorrhoidectomy is significant and generally requires narcotics for relief. The fear of a bowel movement because of pain may lead to fecal impaction in a few patients. Co-morbid conditions such as diabetes, HIV and heart disease increase the risks of local treatment, but do not alter the type of complications. There may be subtle changes in continence of gas or liquid stool following local treatment or surgery, but they are rarely socially significant. Injury to the anal sphincter muscle is a recognized risk, but is extremely rare in experienced hands.
Anal incontinence is a rare complication of surgery for hemorrhoidal disease.
Most hemorrhoidal disease can be treated in the office. Surgical hemorrhoidectomies can generally be carried out under local anesthesia with sedation. A brief stay in the hospital may be necessary for pain control, depending on the patient's pain threshold. Symptoms following local treatment are minimal after 24-48 hours, with patient activity limited only by discomfort. After surgical hemorrhoidectomy, pain may persist for two weeks, with activity again permitted by the level of comfort.