Clinical Profile of Haemorrhoid Cases Admitted in Various Tertiary Care Hospitals in an Urban Area of Southern India PC14-PC18
Dr. Nitin Joseph,
Associate Professor, Department of Community Medicine, Kasturba Medical College, Light House Hill Road,
Manipal Academy of Higher Education, Mangalore-575001, Karnataka, India.
Introduction: Clinical presentation of haemorrhoids is varied resembling number of anorectal diseases.
Aim: To assess risk factors, clinical profile and management practices of haemorrhoid cases.
Materials and Methods: This retrospective record based study was done at a government and private tertiary care hospital in Mangalore. Data from medical records of 220 haemorrhoid cases, over the past 10 years were collected and analysed. Chi-square test was used to test association.
Results: Out of the 220 cases, 196 (89.1%) were males, 87.3% were unskilled workers and 123 (55.9%) were from urban areas. Among the cases, 96.5% were non-vegetarians, 150 (68.2%) gave history of frequent lifting of heavy weights, 69 (31.4%) had positive history of prolonged standing and 68 (30.9%) had history of constipation. Majority of cases had internal haemorrhoids 177 (80.5%) and were of third degree 92 (41.8%) variety. As many as 99 (45%) presented with haemorrhoids in 3 o’ clock position. The most common presentation was rectal bleeding 175 (79.5%) followed by anal pain 55 (25%). Rectal bleeding was present among most cases (80.8%) with internal haemorrhoids while majority of cases (28.2%) with external haemorrhoids complained of anal pain. Proctoscopy was the most common investigative procedure performed in 75% cases. Among conservative procedures, majority of cases 79 (35.9%) received warm sitz bath. Ferguson haemorrhoidectomy (closed haemorrhoidectomy) was the most common surgical procedure done in 83.8% cases. The outcome of management was recovery in 214 (97.3%) cases and recurrence reported in 6 (2.7%) cases.
Conclusion: The high risk groups identified in this study such as non-vegetarians and those with history of frequent lifting of heavy weights need to be made aware of the risk of developing haemorrhoids. Suitable changes in their lifestyles will be useful in prevention of haemorrhoids. Information on its common clinical presentation would be useful in screening activities.