Our Summary

This study looked at whether it was useful to use antibiotics during a specific type of hemorrhoid surgery (Milligan Morgan hemorrhoidectomy) for severe cases of hemorrhoids. They had three groups of patients: one group didn’t get any antibiotics, one group got antibiotics just before anesthesia, and one group got antibiotics before anesthesia and again six hours after the operation.

They found out that the patients’ pain levels and other symptoms like swelling, bleeding, and urinary retention were pretty much the same across all three groups. They also found that the levels of white blood cells, neutrophils, and C-reactive protein (these are all things that can indicate inflammation or infection) were the same across all groups after surgery. But, they did notice that these levels increased in the first two groups three days after surgery. The recurrence rate of hemorrhoids after a year was quite low, at 1.4%.

So, the conclusion was that using antibiotics during this type of hemorrhoid surgery didn’t really make a difference to the patients’ outcomes.

FAQs

  1. Did using antibiotics during the Milligan Morgan hemorrhoidectomy have an effect on patients’ pain levels and other symptoms?
  2. Did the use of antibiotics during surgery have an impact on the levels of white blood cells, neutrophils, and C-reactive protein after surgery?
  3. What was the recurrence rate of hemorrhoids a year after the Milligan Morgan hemorrhoidectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hemorrhoidectomy is to follow post-operative care instructions carefully to promote healing and reduce discomfort. This may include taking pain medication as prescribed, eating a high-fiber diet to prevent constipation, staying hydrated, and avoiding straining during bowel movements. It’s also important to keep the surgical area clean and dry, and to avoid heavy lifting or strenuous activity for a certain period of time as advised by the doctor. If there are any concerns or unusual symptoms, it’s important to contact the doctor for further guidance.

Suitable For

Hemorrhoidectomy is typically recommended for patients with severe cases of hemorrhoids that have not responded to other treatments such as lifestyle changes, medications, or minimally invasive procedures. Patients who may be recommended for hemorrhoidectomy include those with:

  • External hemorrhoids that are causing severe pain or discomfort
  • Internal hemorrhoids that are causing bleeding or prolapse
  • Recurrent hemorrhoids that have not responded to other treatments
  • Large hemorrhoids that are interfering with daily activities or quality of life

It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if hemorrhoidectomy is the most appropriate treatment for their individual case.

Timeline

Here is a brief timeline of what a patient may experience before and after a hemorrhoidectomy:

Before surgery:

  • Consultation with a doctor to determine if surgery is necessary
  • Pre-operative tests and evaluations
  • Preparing for the surgery by following specific instructions from the doctor, such as fasting before the procedure

During surgery:

  • Anesthesia is administered
  • The surgeon removes the hemorrhoids through a surgical procedure, such as a Milligan Morgan hemorrhoidectomy
  • The patient is monitored closely during and after the surgery for any complications

After surgery:

  • The patient may experience pain, discomfort, and swelling in the rectal area
  • The patient may need to take pain medication and follow a specific diet to aid in recovery
  • The patient may need to refrain from certain activities, such as heavy lifting or strenuous exercise, for a period of time
  • Follow-up appointments with the doctor to monitor healing and address any concerns
  • The patient may need to make lifestyle changes, such as increasing fiber intake and staying hydrated, to prevent future hemorrhoids

Overall, recovery from a hemorrhoidectomy can vary from person to person, but with proper care and follow-up, most patients can expect to experience relief from their symptoms and improved quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a hemorrhoidectomy procedure?
  2. What is the typical recovery time and expected level of pain after a hemorrhoidectomy?
  3. Are there any alternative treatments or procedures that could be considered for my hemorrhoids?
  4. How many hemorrhoidectomies have you performed, and what is your success rate with this procedure?
  5. Will I need to take any specific precautions or follow any special instructions before or after the surgery?
  6. How long will I need to stay in the hospital after the procedure?
  7. What is the likelihood of experiencing a recurrence of hemorrhoids after the surgery?
  8. Are there any specific dietary or lifestyle changes I should make to help prevent future hemorrhoids?
  9. Will I need any follow-up appointments or examinations after the surgery?
  10. Are there any specific factors about my health or medical history that may impact the success of the surgery?

Reference

Authors: Liu J, Lv L, Qian HH, Sun PL, Zhang D. Journal: Asian J Surg. 2024 Jan;47(1):169-175. doi: 10.1016/j.asjsur.2023.06.069. Epub 2023 Jul 13. PMID: 37451888