Prolapsed Hemorrhoids Treatment Options
DOI:
https://doi.org/10.22317/imj.v4i2.815Abstract
Objectives: Hemorrhoids are among the most common complaints worldwide, ranging from painless rectal bleeding to prolapsed hemorrhoids. Hemorrhoids can be classified into external and internal types. External hemorrhoids do not need any specific treatment unless they are cause pain, bleed or become thrombosed.
Methods: This study is a prospective study (case series study), approved by ethical committee, conducted on Fifty patients with prolapsed pile, 46 of whom were males and 4 were females and were collected in the span of 2 years from Sulaymaniyah Teaching hospital and Shar hospital. Topical application of mannitol included a gauze soaked with mannitol solution and applied to the prolapsed hemorrhoids.
Results: All the patients presented with prolapsed hemorrhoids, 46 of them were males and 4 of them were females. Most of patients were heavy workers (46%), while students made up (18%), employee (22%), retired (8%) and free workers (6%). The most common clinical presentations were constipation (72%), anal pain (68%), bleeding (50%), itching (14%), discharge (4%) and prolapse only (6%).
Conclusions: Prolapsed hemorrhoid can be managed conservatively by topical application of mannitol as it decreases edema, causing the hemorrhoidal tissue to retract to its position.
References
2. Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol 2012; 18: 2009-2017 [PMID: 22563187] )
3. Thomson WH. The nature and cause of haemorrhoids. Proc R Soc Med 1975; 68: 574-575 [PMID: 1197343])
4. Aigner F, Gruber H, Conrad F, Eder J, Wedel T, Zelger B, Engelhardt V, Lametschwandtner A, Wienert V, Böhler U, Margreiter R, Fritsch H. Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease. Int J Colorectal Dis 2009; 24: 105-113 [PMID: 18766355 DOI: 10.1007/s00384-008-0572-3])
5. Lee JH, Kim HE, Kang JH, Shin JY, Song YM. Factors associated with hemorrhoids in korean adults: korean national health and nutrition examination survey. Korean J Fam Med 2014; 35: 227-236 [PMID: 25309703])
6. Alonso-Coello P, Guyatt G, Heels-Ansdell D, et al. Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev 2005; 4: CD004649.)
7. Misra MC and Imlitemsu. Drug treatment of haemorrhoids. Drugs 2005; 65: 1481–1491 )
8. Cerera N, Liolitsa D, Iype S, et al. Phlebotonics for haemorrhoids. Cochrane Database Syst Rev 2012; 8: CD004322)
9. Scientific & Clinical Evidence of Combining an Anti-Oedematous Solution with a Specific Pro-Inflammatory Cytokine Inhibitor is the Only Approach for the Treatment of Hemorrhoids Ravi Shrivastava PhD MBA DVM1*, Monika Rousse2 , Nathalie Cucuat2 , Lucille Rouvier2 , Aurore Sainte-Martine2 , Léa Shrivastava2 , Christiane Shrivastava2 , and Rémi Shrivastava3 1 Director of Research VITROBIO Pharma, France 2 VITROBIO Pharma, France 3 NATURVEDA Research Institute, France
10. Hospital Episode Statistics—Hospital Outpatient activity. Main procedure or intervention, http:// content.digital.nhs.uk/hesdata (2013, accessed 31 May 2017).
11. Mann CV, Russell RC, Williams NS. Bailey and Love's Short Practice of Surgery. 22nd ed. London: Chapman and Hall; 1995. pp. 873–4. [Google Scholar] [Ref list])
12. Ambrose NS, Morris D, Alexander-Williams J, Keighley MR. A randomized trial of photocoagulation or injection sclerotherapy for the treatment of first-and second – degree hemorrhoids. Dis Colon Rectum. 1985;28:238–40. [PubMed] [Google Scholar])
13. Mashiah A, Mashiah T. Cryosurgery for life-threatening bleeding hemorrhoids in the elderly. J Am Geriatr Soc. 1984;32:62–3. [PubMed] [Google Scholar]
14. O’Callaghan JD, Matheson TS, Hall R. Inpatient treatment of prolapsing piles: Cryosurgery versus Milligan –Morgan haemorrhoidectomy. Br J Surg. 1982;69:157–9. [PubMed] [Google Scholar]
15. Konsten J, Baeten CG. Hemorrhoidectomy Vs Lord's method: 17-year follow-up of a prospective randomized trial. Dis Colon Rectum. 2000;43:503–6. [PubMed] [Google Scholar]
16. Mortensen PE, Olsen J, Pedersen LK, Christiansen J. A randomized study on haemorrhoidectomy combined with anal dilatation. Dis Colon Rectum. 1987;30:755–7. [PubMed] [Google Scholar
17. Hodgson WJ, Morgan J. Ambulatory hemorrhoidectomy with CO2 LASER. Dis Colon Rectum. 1995;38:1265–9. [PubMed] [Google Scholar
18. Armstrong DN, Ambrose WL, Schertzer ME, Orangio GR. Harmonic scalpel Vs electro-cautery hemorrhoidectomy: A prospective evaluation. Dis Colon Rectum. 2001;44:558–64. [PubMed] [Google Scholar]
19. Kwok SY, Chung CC, Tsui KK, Li MK. Double blind randomized trial comparing Ligasure and Harmonic Scalpel hemorhoidectomy. Dis Colon Rectum. 2005;48:344–8. [PubMed] [Google Scholar]
20. Cheetham MJ, Mortensen NJ, Nystrom PO, et al. Persistent pain and faecal urgency after stapled haemorrhoidectomy. Lancet 2000; 356: 730–733. 32. Thaha MA, Irvine LA, Steele RJ, et al. Postdefaecation pain syndrome after circular stapled anopexy is abolished by oral nifedipine. Br J Surg 2005; 92: 208–210.)
21. Giordano P, Overton J, Madeddu F, et al. Transanal hemorrhoidal dearterialization: a systematic review. Dis Colon Rectum 2009; 52:))
22. Sprague AH, Khalil RA (2009) Inflammatory Cytokines in Vascular Dysfunction and Vascular Disease. Biochem Pharmacol 78: 539-552
23. Shrivastava R, Shrivastava L (2013) Patent: A filmogen glycerol for topical application. PCT/EP2013/061835.)
24. Zhang JM, An J (2007) Cytokines, Inflammation and Pain. Int Anesthesiol Clin 45: 27-37.)