Management of Haemorrhoids - A Personal Local Experience

Background: The aim of the study was to analyze the management of patients presenting with haemorrhoids in the local set up.
Methods: The records of all patients treated in the private consulting rooms of the author in Hurlingham in Nairobi for haemorrhoids by the author were reviewed.
Results: A total of 300 patients with haemorrhoids were treated of which approximately two thirds were less than 50 years of age. The male to female ratio was 2.15: 1 and the commonest mode of presentation was haematochlesia. Approximate 25% of the patients were diagnosed by anal inspection alone while 75% had internal non-prolapsed haemorrhoids. 96% of the patients had a 60cm colonoscopy at which 2.8% were found to have a rectal malignancy. Seven patients required emergency surgery for their painful thrombosed external haemorrhoids and 21 patients had a haemorrhoidectomy. Band ligation was performed in 181 patients. None of these had any major complications while two of the haemorrhoidectomy patients had major complications.
Conclusion: Haemorrhoids are a common problem and should be diagnosed accurately since appropriate management prevents unnecessary morbidity. Haemorrhoids maybe secondary to proximal rectal pathology. Where possible band ligation provides good symptom relief.
Recommendation: It is advisable to perform a 60cm colonoscopy before treating haemorrhoids.