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. 2021 Oct;37(5):306-310.
doi: 10.3393/ac.2020.08.10. Epub 2020 Sep 18.

Is There a Relationship Between Stool Consistency and Pain at First Defecation After Limited Half Hemorrhoidectomy? A Pilot Study

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Is There a Relationship Between Stool Consistency and Pain at First Defecation After Limited Half Hemorrhoidectomy? A Pilot Study

Takaaki Yano. Ann Coloproctol. 2021 Oct.

Abstract

Purpose: While the first defecation pain is a problem following hemorrhoidectomy, it is unknown whether the stool consistency has an influence on pain. This pilot study aimed to investigate whether the intensity of defecation pain varied according to stool consistency.

Methods: This prospective cohort study evaluated patients who underwent hemorrhoidectomy in combination with injection sclerotherapy for grade III or IV hemorrhoids. The pain intensity and stool form during the first postoperative defecation were self-recorded by the patients using a visual analogue scale (score of 0-10) and Bristol Stool Form Scale, respectively. The patients were classified into 3 groups according to stool consistency, and the intensity of defecation pain was compared among the groups using analysis of variance.

Results: A total of 61 patients were eligible for this study and were classified into the hard stool (n=15), normal stool (n=21), and soft stool groups (n=25). No significant intergroup differences were identified in the intensity of pain at defecation (P=0.29).

Conclusion: This pilot study demonstrated that there were no clear differences in pain intensity during the first defecation after surgery among the 3 groups with different levels of stool consistency.

Keywords: Hemorrhoidectomy; Hemorrhoids; Loose stool; Pain; Postoperative complication.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Schematic diagram showing the procedure of limited half hemorrhoidectomy with aluminum potassium sulfate and tannic acid (ALTA) injection sclerotherapy. Gray dotted lines indicate removal of 2 external hemorrhoids (EH) at the dentate line via diathermy. Black dotted arrows indicate injection of ALTA solution into 3 internal hemorrhoids (IH).
Fig. 2.
Fig. 2.
Patient flow diagram.
Fig. 3.
Fig. 3.
Box plot of defecation pain scores in relation to degree of stool consistency. Median values (horizontal lines), interquartile range (boxes), range (error bars), and mean (cross marks) excluding outlier (circle) are shown.

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