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 pathoge-nesis is based on old theories and vascular mechanical which are nevertheless based on the current therapeutic approach. General Aim of the Study: To study hae-morrhoids' 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. A. Coulibaly et al. 344