The Haemorrhoids’ Pathology: Epidemiological, Diagnostic, Therapeutic and Evolutionary Aspects

Abstract

Background: Hemorrhoidal disease is most frequently encountered in proctology affection; it is defined by signs or symptoms attributed to hemorrhoids. Its pathogenesis is based on old theories and vascular mechanical which are nevertheless based on the current therapeutic approach. General Aim of the Study: To study haemorrhoids’ pathology in order to improve its management. Methodology: A retrospective cross-sectional study was conducted over a period of two (2) years from 1 January 2012 to 31 December 2013. Data were collected from outpatients records in hepato-gastroenterology and digestive surgery services at “Polyclinique Notre Dame de la Paix” in Ouagadougou (2294 files). Results: 140 cases of haemorrhoids were recorded during our study period. The frequency was 6.1% of consultations. Males predominated with 75.71% of patients (sex ratio = 3.12). The average age was 39.58 years. Civil servants were most affected by this disease (60%). Rectal bleeding was the most common reason of consultation (52.14%). The crown shape was predominated (59%). The frequency of external haemorrhoids was the highest (65.71%) and stage 4 (40.79%) was the most represented. Anal fissure was the proctologic pathology, the most associated to haemorrhoids (17.14%). Medical treatment concerned 89.28% of patients with 69.6% of favorable short-term evolution. No instrumental treatment was performed. Surgical treatment consisted of 10.71% of patients and the technique used was the Milligan-Morgan performed under spinal anesthesia. The postoperative complications were mainly represented by anal intense pain and acute urinary retention. The healing period of wounds was on average 6 weeks. Conclusion: The hemorrhoid has often underestimated in our regions. The instrumental treatment is nonexistent and should take an important place; it must be an indication before surgery.