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Thread: hemorrhoidectomy

  1. #1
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    Unhappy hemorrhoidectomy

    I am a T4/5 complete paraplegic woman, 58 years old, 28 years post injury. Among a lot of other problems related to the accelerated aging process I experience the last 2-3 years, i have very frequent episodes of AD every day, specially in the afternoon, 7-9 pm, and so i have to take antihypertensive drugs sublingually (captopril) and then face the hypotension, the sensation of empty or numb head and the tinnitus. I have a third grade hemorrhoidal disease ie mucosal prolapse reducible after manual handling and anal sphincter hypertonia which causes to me difficulties and AD during bowel program. I did not find any other cause for AD, my suprapubic catheter is working, I have done intravescical botulinum injection, plain film (intestine full of gas),cystoscopy, colonscopy, (many polypes) i don?t have any bone fractures, pressure sores, kidneys or gallbladder stones, no syringomyelia and i tend to consider ? maybe i am wrong- the hemorrhoidal disease and the anal sphincter hypertonia as the cause for AD. I feel good only 2-4 hours after the bowel program and if it is a succesfull one, (peristeen) ,the rest of the day, I feel belly discomfort and abdominal pain, non the old pain i am a complete, a new one but is always pain, intestinal spasms with or without AD or with or without sweating which always comes like a rendez vous 7-9 in the afternoons or 11-13 in the morning. The morning all the symptoms are always milder. 2-3 hours after eating i have intestinal spasms and if I do not pass any intestinal gas during the resting postprandial time which is very common for me, I have to suffer the hole afternoon or go back to bed and try to eliminate some gas by pressing my belly. I did a very conservative Lords anal stretch and I drink a medicinal natural herb which helps me to eliminate some gas but not always. After this operation my blood pressure during AD episodes is lower (150/100 instead of 190/110 before operation) but is still present. My surgeon suggested me a Longo stapler hemorrhoidectomy but I am very concern for the operation itself and specially for the postoperative period because of Autonomic Dysreflexia. Does anybody have similar problems or experienced a Longo stapler hemorrhoidectomy? Are there any other alternatives?

  2. #2
    I think you should consider the surgery as your have persistent AD. Have you tried Nitropaste for the AD?
    CWO

  3. #3
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    hemorrhoidectomy

    Quote Originally Posted by SCI-Nurse View Post
    I think you should consider the surgery as your have persistent AD. Have you tried Nitropaste for the AD?
    CWO
    I tried nitropaste when i had a very small fissure which is healed, i also use lidocaine gel and stool softener. I am seriously considering the surgery but we do not know which type of operation is more apropriate for sci. My surgeon suggest me Longo stapler but he is wondering for the postoperative period since i am very sensitive to AD and he has no experience with sci. Any bibliography about this method? I am also trying to understand why my dysreflexia comes always in the afternoon, like an appointment, except when the catheter is blocket which can happen any time. Is this because of the accumulation of gas after lunch? Is there anything to help the elimination of gas? All the vegetables and fruits are producing gas, cereals too. Thank you for the reply . Very difficult to find another doctor with sci experience in my place.

  4. #4
    I had similar symptoms and saw countless specialists and tried all kinds of drugs and treatments. I got relief with a different diet.

    Maybe change your diet or add some enzymes or HCL Betaine to help your food digest better. Fermentation in your gut is caused as a by product when bacteria eats the undigested food. I used to get terribly uncomfortable and have dysreflexia from the gas in my belly. Antibiotic use can contribute to a bacterial overgrowth especially in the small intestine area. Hypersensitivity from gas pressure in the colon too can cause pain and AD.

    You might experiment by eliminating foods that are fermentable carbohydrates. You can find these food lists by googling FODMAP diet. FODMAP is only meant to be a short term elimination diet, do not stay on it too long and risk starving your body of nutrition.

    google SIBO to learn about small intestinal bacteria overgrowth.

    SIBO is a relatively new diagnosis. In my opinion, SIBO isn't a diagnosis for a disease, it's a symptom of something else. You need to figure out why your body isn't digesting right or why you have a bacterial overgrowth and fix that.

  5. #5
    Do you use the prebiotics and probiotics?- can be found in some yogurt and then over the counter.
    AD can be caused by any irritation so it is possible- have you tried taking antigas medication at lunch time.
    Diet without foods prone to produce more gas?
    CWO

  6. #6
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    Thank you very much, the last days i am on a diet without foods prone to produce more gas. I will try to keep on this diet and see, but i did not find any antigas medication which helped me. I also take prebiotics. When i have my bowel program every day (instead of every other day as usual) i have less intestinal spasms and sweating but AD is always there waiting for me the same time in the afternoon.Thank you again.

  7. #7
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    I use prebiotics, i am on diet without foods prone to produce more gas. I tried, in the past, antigas medication without results, i would appreciate any suggestion about these, I have "better" results with a medicinal herb. When i have my bowel program every day (instead of every other day as usual) i have less intestinal spasms and sweating but AD is always there waiting for me the same time in the afternoon. I know i have to do the hemorrhoidectomy but i am scare to death specially for the post operative period, i am so prone to AD, and i do not know if the Longo stapler type, which my surgeon suggests me is appropriate for people with sci.( my doctor has no experience with sci people). I am afraid that i am candidate for my biggest nightmare colostomy.Thank you for the replay

  8. #8
    In my experience:

    PREBIOTICS: Most probiotics are fermentable carbs and if you have a bacterial overgrowth, you will suffer even more. Probiotics are meant to feed the bacteria, something you don't want to be doing if they are the bacteria causing the fermentation that fills you up with gas. Inulin is a common prebiotic, often added to probiotics. I think it is from the hickory root. The tiniest bit ad I would blow up to such painful states, I couldn't handle it. I ate a Fiber One bar and ended up in ER. One of the main ingredients is chicory root. In fact, it's chock full of sugar alcohols and everything restricted on a FODMAP diet. Here's a link that lists the ingredients. Fiber One Bars - Friend or Foe

    YOGHURT - (ACTIVIA ESPECIALLY): Yoghurt can cause gas in your stomach if you are lactose intolerant. Lactose is a sugar that takes the longest to digest. For that reason, many people have a problem with it because it gets down into the small intestine without being digested so its left over for the bacteria to eat and ferment.

    Activia yogurt (Dannon) has its own patented Bifidus Regularis bacteria. At first, I was impressed by the immediate effect eating it had on my bowels. However, after a week, I suffered with AD and terrible intestinal cramping. It was awful. We discussed it on a forum thread here awhile back. Activia & Gas

    ANTI GAS MEDS: Pretty ineffective. Only a
    bandaid that pulls smaller bubbles together to create a larger one that hopefully leaves the body easier.

  9. #9
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    Thank you again for the suggestions, seems to me that we are facing similar, if not the same, problem. I translated all the FODMAP and SIBO, and i found a lot of food i was still eating which i should not according to the list. For more than a year i do not eat any kind of beans, cabbage, onions, garlic, but in my diet there was in small quantities bread, pasta, apples and beetroots.
    Never tried activia from fear it should be very drastic, only greek yogurt which is not so bad. I did not find chocolate in the forbidden foods, what do you say about that, i am addicted to the black one. I take probiotics, (lactobacilus acidofilus and bifidobacteria), and not prebiotics as i wrote by mistake in the prior message. For how long do you have this problem, what other treatments did you tried, and how long time you needed to get relief? What about AD? is it gone? I am afraid it is gone a be a long travel .. if it works for me . I started the diet hoping for results, thanks again

  10. #10
    Hi Vaggelio,

    I had a hemorrhoidectomy and its the best thing I ever did. I suffered terribly for years with the same severity / diagnosis you mentioned.

    The surgery is not very complicated or technical from the surgeons perspective. The worse part is the lengthy recovery (a good 5 months until fully healed / no seeping. Having to use pads. ) You are not stuck in bed though. I was able to resume sitting the next day.

    My surgeon used devolving stitches. Staples would worry me as well in terms of A/D and B/P. As I understand it, there are different hemorrhoidectomy techniques.

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