Our Summary

This research paper reviews various methods used to reduce pain after a hemorrhoidectomy, a surgery where hemorrhoids are removed. The researchers examined 157 studies and additional data from 15 meta-analyses.

They found four main strategies to reduce pain after this surgery. The use of local anesthesia, possibly combined with sedation, was seen as the most effective method. They also found that certain surgical techniques, like a closed (Ferguson) hemorrhoidectomy with special equipment, were recommended.

Other methods to reduce pain included adding another small surgical procedure to the hemorrhoidectomy, or using a chemical to help numb the area. However, these methods may increase the risk of loss of bowel control.

Applying certain creams or ointments, such as anesthetic cream or 10% sucralfate ointment, was also found to help reduce post-surgery pain. Additionally, taking certain medications like oral metronidazole, flavonoids, and laxatives after the surgery was associated with less pain.

In conclusion, the paper provides a comprehensive review of proven methods to decrease pain after a hemorrhoidectomy. It also suggests areas for future research on this topic.

FAQs

  1. What are the main strategies to reduce pain after a hemorrhoidectomy according to the research paper?
  2. What are the potential risks associated with adding another small surgical procedure to the hemorrhoidectomy or using a chemical to numb the area?
  3. What types of medications or topical treatments have been found to help reduce post-surgery pain after a hemorrhoidectomy?

Doctor’s Tip

Therefore, a helpful tip a doctor might give to a patient undergoing a hemorrhoidectomy is to discuss with them the various methods available to reduce post-surgery pain. This may include using local anesthesia, specific surgical techniques, applying certain creams or ointments, and taking medications as prescribed. It is important for the patient to follow their doctor’s recommendations closely to ensure a smoother recovery process.

Suitable For

Patients who are typically recommended for a hemorrhoidectomy are those who have severe or recurring hemorrhoids that do not respond to conservative treatments such as dietary changes, topical medications, and lifestyle modifications. These may include patients with large external hemorrhoids, thrombosed hemorrhoids, or internal hemorrhoids that have prolapsed and are causing significant discomfort or bleeding.

Patients who have tried other treatment options without success and are experiencing significant pain, bleeding, itching, or difficulty with bowel movements may benefit from a hemorrhoidectomy. Additionally, patients with underlying conditions such as inflammatory bowel disease, chronic constipation, or pregnancy-related hemorrhoids may also be candidates for this surgery.

It is important for patients considering a hemorrhoidectomy to discuss their symptoms and treatment options with a healthcare provider to determine if surgery is the best course of action for them. The decision to undergo a hemorrhoidectomy should be made after a thorough evaluation of the patient’s medical history, symptoms, and overall health.

Timeline

Before the hemorrhoidectomy, a patient may experience symptoms such as pain, itching, and bleeding in the anal area. They may have tried conservative treatments such as over-the-counter creams, stool softeners, and sitz baths to alleviate their symptoms.

After the hemorrhoidectomy, the patient will undergo the surgical procedure to remove the hemorrhoids. They will likely experience pain, discomfort, and some bleeding in the immediate post-operative period. The use of pain medications, sitz baths, and ice packs may be recommended to help manage these symptoms.

As the patient continues to recover, they may experience some discomfort and pain during bowel movements. It is important for the patient to follow their healthcare provider’s instructions for post-operative care, including proper wound care and maintaining good hygiene to prevent infection.

Overall, the recovery period after a hemorrhoidectomy can vary from a few days to a few weeks, depending on the individual patient and the extent of the surgery. It is important for patients to communicate with their healthcare provider about any concerns or complications during the recovery process.

What to Ask Your Doctor

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

  1. What type of anesthesia will be used during the surgery?
  2. What surgical technique will be used for the hemorrhoidectomy?
  3. Are there any additional procedures or medications that can be used to reduce post-surgery pain?
  4. What are the potential risks and side effects associated with the pain management methods recommended?
  5. How long is the expected recovery time after a hemorrhoidectomy?
  6. Are there any specific post-operative care instructions or medications that should be followed to reduce pain?
  7. What are the long-term outcomes and potential complications of a hemorrhoidectomy?
  8. Are there any lifestyle changes or dietary modifications that can help reduce pain and promote healing after the surgery?
  9. Are there any alternative or complementary therapies that can be used in conjunction with traditional pain management methods?
  10. What follow-up appointments will be necessary after the surgery to monitor pain levels and healing progress?

Reference

Authors: Lohsiriwat V, Jitmungngan R. Journal: Medicina (Kaunas). 2022 Mar 12;58(3):418. doi: 10.3390/medicina58030418. PMID: 35334594