The Complications of Haemorrhoids

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Complications:

Haemorrhoid is a more common disease now a days. It may seem as a simple disease, but complications may turn it into an medical emergency. The most important of the complications is the development of severe anaemia as in the case of worse bleeding piles. It is not associated with any pain in most cases.

Profuse haemorrhage is not rare. Most often, it occurs in the early stages of the

second degree. The bleeding occurs mainly externally, but it may continue internally after

the bleeding haemorrhoid has retracted or has been returned. In these circumstances, the

rectum is found to contain blood.

The other most important complications include,

1. Strangulation

One or more of the internal haemorrhoids prolapse and become gripped by the

external sphincter. Further congestion follows because the venous return is impeded.

Second-degree haemorrhoids are most often complicated in this way.

Strangulation is accompanied by considerable pain. Unless the internal

haemorrhoids can be reduced with in 1 or 2 hours strangulation is followed by

thrombosis.

2. Thrombosis

The affected haemorrhoid or haemorrhoids become dark purple or black and feel

solid. Considerable oedema of the anal margin accompanies thrombosis. Once the

thrombosis has occurred, the pain of strangulation largely passes off, but tenderness

persists. Superficial ulceration of the exposed mucous membrane often accompanies

strangulation with thrombosis.

3. Gangrene

Gangrene is due to the loss of blood supply to a particular area. Gangrene occurs when strangulation is sufficiently tight to constrict the arterial supply of the haemorrhoid.Very occasionally; massive gangrene extends to the mucous membrane with in the anal canal and rectum. it can undergo further putrifaction.

4. Fibrosis

After thrombosis, internal haemorrhoids sometimes become converted into

fibrous tissue. The fibrosed haemorrhoids is at first sessile, but by repeated traction

during prolapse at defaecation, it becomes pedunculated and constitutes a fibrous polyp

that is readily distinguished by its white colour from an adenoma, which is bright red.

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5. Suppuration

It is uncommon. It occurs as a result of infection of a thrombosed haemorrhoid.

Throbbing pain is followed by perianal swelling, and a perianal or sub mucous abscess are the

results.

6. Pyle phlebitis (portal pyaemia)

Theoretically, infected haemorrhoids should be a potent cause of portal pyaemia

and liver abscess. but it is very rare in practice.

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