Assessment of Oral Metronidazole in Pain Management Post Haemorrhoidectomy

Abstract

Background: Haemorrhoids are a very popular disease. Approximately 50% to 66% of people have problems with haemorrhoids at some point in their lives. The pathophysiology of haemorrhoids is not exactly well known. Theories were developed trying to understand the pathophysiology of haemorrhoids e.g., varicose vein theory, anal lining sliding theory, hyperactivity of internal sphincter theory and vascular hyperplasia theory. Diagnosis is made by integration of available clinical data (symptoms), clinical examination and investigations. Although, we are using the term to refer to the disease resulting from their congestion and swelling, it is hard to evaluate the exact prevalence of haemorrhoids in a certain community as a lot of people suffering from the condition don’t seek for medical advice Objectives: This thesis study was done to assess the efficacy of oral metronidazole administration in management of post haemorrhoidectomy pain. Patients and Method: This study was conducted at El Demerdash Hospital and Damanhour National Institute in 1/1/2018 to 30/6/2018. 80 patients presented to the General Surgery Clinic and met the inclusion criteria in six month duration. The participants were divided into two groups 40 in each group. Results: When the results of both groups were put in a comparison, it showed that group A had a significant lower pain values in day 1 and 3 than group B but both groups(p=0.043*,p= 0.004)results were equivocal in day seven with no significant difference(p=0.268). Also results showed that group B needed more analgesics than group A and that confirms that metronidazole do decrease pain experienced by the patients after the operation and decreased their need for analgesics(p=0.043). Otherwise, both groups show no significant differences according to the time of first bowel movement(p=0.967). Conclusion: Oral Metronidazole administration post haemorrhoidectomy significantly decrease the post-operative pain and decrease the need for more analgesics with no significant effect on the time of the first bowel movement.