Crohn’s disease: is haemorrhoid surgery safe?

  • Inflamm Bowel Dis
  • 21 Oct 2019

  • International Clinical Digest
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Takeaway

  • Patients with Crohn’s disease (CD) may safely undergo surgical treatment for haemorrhoid after nonoperative approaches fail to help them.

Why this matters

  • Most physicians avoid an excisional haemorrhoidectomy in patients with CD because of concerns about impaired wound healing leading to the need for proctectomy.

Study design

  • Researchers analysed the health records of patients with CD undergoing excisional haemorrhoidectomy for symptomatic haemorrhoids (n=36; women, 56%; median age, 49 [range, 21-77] years), comparing patient demographics, CD-related clinical characteristics, postoperative complications, and the need for further therapy or surgical intervention.
  • Funding: None disclosed.

Key results

  • Most common symptoms included pain (44%), bleeding (33%), and prolapse (22%).
  • 16 (44%) patients had nonoperative therapy before surgery.
  • 24 (67%) patients had other perianal diseases.
  • 4 (11%) patients developed post-haemorrhoidectomy complications, including stricture, perianal abscess, nonhealing wound, and haemorrhoidal recurrence (median follow-up, 31.5 [range, 1-255] months).

Limitations

  • The study was retrospective with a small number of patients, precluding definitive conclusions about outcomes based on different medical regimens.

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