Hemorrhoidal Disease: What Treatment Is Available at Gabriel Touré University Hospital?

Abstract

Hemorrhoidal disease is the most common anal condition, manifesting itself intermittently. It requires rigorous management, with treatment and monitoring adapted to the stage of the disease. The objective was to evaluate the management of hemorrhoidal disease in the hepatology and gastroenterology department of the GABRIEL TOURE University Hospital Center. This was a longitudinal, descriptive analytical study with prospective data collection over one year, conducted in the hepatology and gastroenterology department of the Gabriel Touré University Hospital. The parameters studied were age, medical history, bowel movement profile, triggering factors, specific symptoms (bleeding, prolapse, pain), duration of the disease, and various treatments. We collected data on 140 patients with Hemorrhoidal Disease (HD) out of 2800 patients, representing a frequency of 5% and 23.33% of the 600 patients with proctological pathology. The sex ratio was 1.69 with a mean age of 35.21 ± 12.45 years, ranging from 15 to 76 years. Patients consulted more for anal pain (53.57%) with constipation (58.57%) as the predominant risk factor. Anal pain (79.29%), followed by anal pruritus (47.86%), were the most common functional signs. More than half of our patients had hemorrhoidal prolapse, i . e ., 55% on anal inspection. In 41 patients (29.28%), the location was “right posterolateral, right anterolateral, and left lateral”. Internal Hemorrhoidal Disease (IHD) was the most common (82.75%), with 76.72% without thrombosis. Goligher stage II was the most frequently observed in our patients (53.13%). Hygiene and dietary rules and regular bowel movements were systematically implemented in all our patients (100%), and 97.86% received drug treatment. Ten patients (7.14%) underwent elastic ligation, with 8 patients (80%) showing favorable progress and 2 patients (20%) developing complications, namely pain and rectal bleeding. Twelve patients (8.57%) received surgical treatment. Regardless of the type of treatment, the outcome was significantly favorable (p = 0.037). The average duration of medical treatment for our patients was 27.58 ± 7.81 days, with extremes of 7 and 60 days. Hemorrhoidal disease is a common condition. Anal pain was the most common functional symptom (79.29%), followed by anal pruritus (47.86%). First-line treatment was medical followed by instrumental. A significant link was found between the progression of the disease and the treatment received (p = 0.037). Surgery should be a last resort.