Our Summary

In this research paper, scientists looked at different ways to help patients manage their pain after having an open hemorrhoidectomy, which is a surgery to remove hemorrhoids. They analyzed 13 different studies that included a total of 731 patients.

The researchers found that most pain relief methods were better than taking no action (placebo). Within 24 hours of surgery, patients experienced less pain when they used treatments like glyceryl trinitrate (GTN), diltiazem, botulinum toxin (BT), sucralfate, and electroacupuncture (EA).

Looking at the pain levels 48 hours and 7 days after surgery, the researchers found that diltiazem, BT, and sucralfate were most effective. EA appeared to help reduce pain during the first bowel movement after surgery.

Diltiazem ointment was identified as the most effective medication for pain relief after an open hemorrhoidectomy, significantly reducing pain within one week of surgery. The next best options were BT and sucralfate. GTN also helped to relieve pain 24 hours after surgery, but there were concerns about it possibly causing headaches, so it should be used carefully. The pain-relieving effects of EA are still uncertain.

The researchers noted that there wasn’t much information available about the safety of these treatments, and encouraged further studies to explore this.

FAQs

  1. What are some effective methods for managing pain after an open hemorrhoidectomy?
  2. What was identified as the most effective medication for pain relief after an open hemorrhoidectomy?
  3. Are there any concerns or side effects associated with these pain relief methods after a hemorrhoidectomy?

Doctor’s Tip

A doctor might tell a patient undergoing a hemorrhoidectomy to consider using diltiazem ointment, botulinum toxin, or sucralfate for pain relief after the surgery. These treatments were found to be effective in reducing pain after the procedure. It is important to follow the doctor’s instructions and closely monitor any side effects that may occur. Additionally, further research is needed to fully understand the safety and effectiveness of these pain relief methods.

Suitable For

Typically, patients who are recommended for hemorrhoidectomy are those who have severe or persistent symptoms of hemorrhoids that do not respond to non-surgical treatments such as dietary changes, over-the-counter medications, or rubber band ligation. These symptoms may include severe pain, bleeding, itching, or prolapse of the hemorrhoids. Hemorrhoidectomy is usually considered as a last resort treatment for patients with significant discomfort or complications from hemorrhoids.

Timeline

Before the hemorrhoidectomy, a patient may experience symptoms such as pain, itching, bleeding, and discomfort in the anal area due to hemorrhoids. They may have tried conservative treatments such as over-the-counter creams, sitz baths, and dietary changes without success.

After the hemorrhoidectomy, the patient will undergo the surgical procedure to remove the hemorrhoids. They will likely experience pain, swelling, and discomfort in the anal area following the surgery. Pain management will be a key aspect of their recovery, and they may be prescribed medications such as diltiazem, BT, sucralfate, or GTN to help alleviate pain. They may also be advised to use treatments like EA to help manage pain during bowel movements.

In the days and weeks following the surgery, the patient will gradually experience a reduction in pain and discomfort as they recover. Diltiazem ointment is identified as the most effective medication for pain relief after an open hemorrhoidectomy, with BT and sucralfate also showing good results. It is important for patients to follow their healthcare provider’s instructions for post-operative care and pain management to ensure a smooth recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hemorrhoidectomy include:

  1. What pain relief options are available to me after the surgery?
  2. Which pain relief method do you recommend based on my individual situation?
  3. Are there any potential side effects or risks associated with the pain relief medications or treatments?
  4. How long can I expect to experience pain after the surgery, and when should I start feeling relief?
  5. Are there any lifestyle changes or home remedies that can help manage pain during the recovery process?
  6. When should I follow up with you after the surgery to discuss my pain management and overall recovery?
  7. Are there any specific activities or behaviors I should avoid to prevent worsening pain or complications post-surgery?
  8. Can you provide me with information on the success rates of pain relief treatments for hemorrhoidectomy patients?
  9. Are there any additional resources or support services available to help me cope with pain and discomfort during the recovery period?
  10. Are there any alternative pain relief methods or treatments that you recommend considering for my specific case?

Reference

Authors: Yang Y, Feng K, Lei Y, Qiu L, Liu C, Li G. Journal: Int J Colorectal Dis. 2023 Jan 7;38(1):4. doi: 10.1007/s00384-022-04294-5. PMID: 36609578