Our Summary

This research paper discusses different kinds of non-cancerous disorders related to the anal and rectal areas. It covers topics such as hemorrhoids, which are swollen blood vessels in the rectum or anus, and conditions like perianal or perirectal abscesses, which are painful collections of pus near the anus. The paper also discusses primary fistulotomy, a surgical procedure used to treat a fistula - an abnormal connection between two body parts - in the anus or rectum.

FAQs

  1. What is a hemorrhoidectomy and when is it necessary?
  2. What are benign anorectal complaints and how are they related to hemorrhoids?
  3. What are perianal/perirectal abscesses and primary fistulotomy?

Doctor’s Tip

After a hemorrhoidectomy, it is important to follow your doctor’s post-operative instructions carefully. This may include taking pain medication as prescribed, keeping the surgical area clean and dry, and avoiding straining during bowel movements. It is also recommended to eat a high-fiber diet, stay hydrated, and avoid sitting for long periods of time to help prevent complications and promote healing. If you experience excessive pain, bleeding, or any other concerning symptoms, be sure to contact your doctor immediately.

Suitable For

Patients who are typically recommended for hemorrhoidectomy are those who have severe or persistent symptoms of hemorrhoids that do not respond to conservative treatment options such as dietary changes, topical medications, or rubber band ligation. These symptoms may include severe pain, bleeding, itching, or prolapse of the hemorrhoidal tissue. Additionally, patients with large external hemorrhoids or internal hemorrhoids that have not responded to other treatments may also be candidates for hemorrhoidectomy. It is important for patients to discuss their symptoms and medical history with their healthcare provider to determine if a hemorrhoidectomy is the best treatment option for them.

Timeline

Before hemorrhoidectomy:

  1. Patient experiences symptoms of hemorrhoids such as pain, itching, bleeding, and swelling in the anal area.
  2. Patient seeks medical advice and is diagnosed with hemorrhoids through physical examination and possibly further tests such as anoscopy or colonoscopy.
  3. Non-surgical treatments such as dietary changes, fiber supplements, topical medications, and lifestyle modifications are tried to manage symptoms.
  4. If non-surgical treatments are ineffective or if the hemorrhoids are severe, the patient is recommended for hemorrhoidectomy surgery.

After hemorrhoidectomy:

  1. Patient undergoes hemorrhoidectomy surgery, which can be performed using various techniques such as traditional excisional surgery, stapled hemorrhoidopexy, or laser surgery.
  2. After the surgery, the patient may experience pain, discomfort, and swelling in the anal area, which can be managed with pain medications, sitz baths, and stool softeners.
  3. Patient is advised to follow post-operative care instructions such as maintaining good hygiene, avoiding straining during bowel movements, and eating a high-fiber diet to prevent constipation.
  4. Follow-up appointments with the surgeon are scheduled to monitor healing and address any complications such as bleeding, infection, or recurrence of hemorrhoids.
  5. Recovery time varies depending on the type of surgery performed and the individual patient, but most patients can return to normal activities within a few weeks.

What to Ask Your Doctor

  1. What is a hemorrhoidectomy and why is it recommended for me?
  2. What are the potential risks and complications of this procedure?
  3. What is the expected recovery time and what can I do to help speed up the healing process?
  4. Are there any alternative treatments or procedures that I should consider?
  5. Will I need to make any changes to my diet or lifestyle after the surgery?
  6. How long will I need to take off work or limit my activities after the procedure?
  7. Will I need any pain medication or follow-up appointments after the surgery?
  8. What signs or symptoms should I watch for that may indicate a complication or need for medical attention?
  9. Are there any long-term effects or considerations I should be aware of after having a hemorrhoidectomy?
  10. Are there any specific instructions or precautions I should follow before and after the surgery to ensure the best possible outcome?

Reference

Authors: Rakinic J. Journal: Adv Surg. 2018 Sep;52(1):179-204. doi: 10.1016/j.yasu.2018.04.004. Epub 2018 Jun 19. PMID: 30098612