Haemorrhoids and Haemorrhoidectomy

Question 1

What are haemorrhoids?

Answer 1

Haemorrhoidal cushions are normal anatomical structures located within the anal canal, usually occupying the left lateral and right anterior and posterior positions. As they enlarge, they can protrude outside the anal canal causing symptoms.

Question 2

What are the risk factors for haemorrhoids?

Answer 2

Age 45-65
Constipation
Pregnancy/ Space Occupying lesion
Hepatic insufficiency
Ascites

Question 3

What is the epidemiology of haemorrhoids?

Answer 3

Since the second half of the 20th century, there appears to be an unexplained decrease in the prevalence of symptomatic haemorrhoidal disease in both the US and England

Question 4

What are the signs and symptoms of haemorrhoids?

Answer 4

Rectal bleeding
Perianal pain and discomfort
Anal pruritis
Tender palpable perianal lesion
Anal mass

Question 5

What investigations should you do for haemorrhoids?

Answer 5

DRE/ anoscope
Colonoscopy
FBC
Stool occult blood/ haem

Question 6

How do you manage haemorrhoids?

Answer 6

Diet and lifestyle advice
Topical corticosteroids
Rubber band ligation
Photocoagulation
Surgical haemorrhoidectomy

Question 7

What are the complications of haemorrhoids?

Answer 7

Anaemia
Thrombosis
Incarceration
Faecal incontinence
Pelvic sepsis 
Anal stenosis

Question 8

What is the prognosis of haemorrhoids?

Answer 8

Good prognosis

Question 9

What is a haemorrhoidectomy?

Answer 9

Surgical excision of haemorrhoids

Question 10

What are the indications for a haemorrhoidectomy?

Answer 10

All patients having grade 4 internal, external or mixed haemorrhoids

Those who have failed to respond to previous treatments

Question 11

What are the complications of a haemorrhoidectomy?

Answer 11

Anal fistula or fissure.
Constipation.
Excessive bleeding.
Excessive discharge of fluid from the rectum.
Fever of 101°F or higher.
Inability to urinate or have a bowel movement.
Pain