Our Summary

This research paper studied how age and the severity of hemorrhoids (a common condition where blood vessels in the anus and lower rectum become swollen and inflamed) affect patients’ treatment choices. The study focused specifically on grade II and III hemorrhoids, which are moderate to severe cases respectively.

The study looked back at the medical records of 961 patients aged 18 to 75 years with these grade of hemorrhoids from 2015 to 2020. The treatments these patients received included surgical removal of the hemorrhoids (hemorrhoidectomy), office procedures, and/or medication management.

The study found that patients with more severe grade III hemorrhoids were more likely to opt for surgery as the first treatment choice compared to those with grade II hemorrhoids (27.6% vs 4.1%). Similarly, younger patients aged 18 to 50 years old were more likely to choose surgery as their initial treatment compared to those aged 51 to 75 years old (around 23% vs 12.8%).

For patients who initially went for medication management or office-based procedures but later needed surgery, the study found no significant difference in the time it took them to proceed to surgery based on the severity of their hemorrhoids or their age.

However, the study did note its limitation: it only looked at age groups and their treatment choice. Personal preferences of both the surgeon and patient could affect these results. The conclusion of the study is that younger patients tend to opt for surgery as their first treatment choice compared to older patients.

FAQs

  1. What were the common treatments for hemorrhoids examined in this study?
  2. Did the severity of the hemorrhoids affect the patients’ choice of treatment, according to the research?
  3. Did age influence the choice of initial treatment for hemorrhoids in this study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hemorrhoidectomy is to make sure to follow post-operative care instructions carefully to promote proper healing. This may include taking prescribed pain medications, keeping the area clean and dry, eating a high-fiber diet to prevent constipation, and avoiding heavy lifting or strenuous activities for a period of time. It’s important to communicate any concerns or changes in symptoms to your healthcare provider to ensure the best possible outcome.

Suitable For

Overall, patients with grade III hemorrhoids are typically recommended hemorrhoidectomy, especially if they are younger in age. This is because surgery is often more effective in treating severe cases of hemorrhoids compared to other treatment options. Older patients may choose to explore medication management or office-based procedures first before considering surgery. Ultimately, the decision on whether to undergo hemorrhoidectomy should be made in consultation with a healthcare provider based on the individual patient’s specific circumstances and preferences.

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 grade II or III hemorrhoids.
  3. Patient may undergo medication management or office-based procedures as initial treatment options.
  4. If symptoms persist or worsen, patient may consider surgical removal of the hemorrhoids (hemorrhoidectomy).

After hemorrhoidectomy:

  1. Patient undergoes hemorrhoidectomy surgery to remove the swollen and inflamed blood vessels in the anus and lower rectum.
  2. Patient may experience post-operative pain, discomfort, and swelling in the anal area.
  3. Patient follows post-operative care instructions provided by the surgeon, including pain management, dietary changes, and hygiene practices.
  4. Patient attends follow-up appointments to monitor healing and address any complications.
  5. Patient gradually recovers from surgery and experiences relief from hemorrhoid symptoms.
  6. Patient may need to make lifestyle changes to prevent recurrence of hemorrhoids.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with hemorrhoidectomy surgery?
  2. How long is the recovery period after a hemorrhoidectomy and what can I expect during the recovery process?
  3. Are there alternative treatment options available for my grade II or III hemorrhoids besides surgery?
  4. What is the success rate of hemorrhoidectomy for patients with my specific severity of hemorrhoids?
  5. How experienced are you in performing hemorrhoidectomy surgeries and what is your success rate?
  6. Will I need to make any changes to my diet or lifestyle after undergoing a hemorrhoidectomy?
  7. How soon after the surgery can I resume normal activities such as work, exercise, and sexual activity?
  8. Are there any long-term effects or complications I should be aware of after undergoing a hemorrhoidectomy?
  9. Can you provide me with information on post-operative pain management and how to prevent recurrence of hemorrhoids in the future?
  10. What is the expected outcome of the surgery in terms of alleviating symptoms and improving my quality of life?

Reference

Authors: Capece SJ, Browning CJ, Barros de Sousa CA, Shaak K, Yoon JY, Sangster W. Journal: Dis Colon Rectum. 2024 Jun 1;67(6):820-825. doi: 10.1097/DCR.0000000000003085. Epub 2024 Feb 23. PMID: 38408874