Free Content A prospective audit of early pain and patient satisfaction following out-patient band ligation of haemorrhoids

Authors: Watson, N.F.S.; Liptrott, S.; Maxwell-Armstrong, C.A.

Source: Annals of The Royal College of Surgeons of England, Volume 88, Number 3, May 2006 , pp. 275-279(5)

Publisher: The Royal College of Surgeons of England

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Abstract:

INTRODUCTION: Information regarding early morbidity, pain and patient satisfaction following band ligation of haemorrhoids is limited. This is the first report to address these issues specifically.

PATIENTS AND METHODS: A total of 183 patients underwent the procedure over a 10-month period. Prospective data were collected using a detailed structured questionnaire regarding symptoms, analgesia requirements and patient satisfaction in the following week.

RESULTS: The response rate was 74% (135/183). Pain scores were highest 4 h following the procedure. At 1 week, 75% of patients were pain-free, with 9 (7%) still experiencing moderate-to-severe pain. About 65% required oral analgesia, most frequently on the day of procedure. Rectal bleeding occurred in 86 patients (65%) on the day after banding, persisting in 32 (24%) at 1 week. Vaso-vagal symptoms occurred in 41 patients (30%) and were commonest at the time of banding. Eighty patients (59%) were satisfied with their experience and would undergo the procedure again. Patients requiring oral analgesia and those experiencing bleeding or vaso-vagal symptoms were significantly less likely to be satisfied with the procedure. Only 57% of the patients surveyed would recommend the procedure to a friend.

CONCLUSIONS: Data from this large cohort of patients suggest that discomfort and bleeding may persist for a week or more following banding of haemorrhoids. Patients should be aware of this in order to make an informed decision as to whether to undergo the procedure, and surgeons should investigate ways of reducing it. Patient satisfaction may be further improved by more accurate counselling regarding the incidence of specific complications.

Keywords: HAEMORRHOIDS; SYMPTOMS; PATIENT CARE; BAND LIGATION

Document Type: Research article

DOI: http://dx.doi.org/10.1308/003588406X98649

Affiliations: 1: Department of Surgery, Queen's Medical Centre, Nottingham, UK

Publication date: 2006-05-01

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  • The Annals of The Royal College of Surgeons of England is the official journal of the College and is published eight times a year in January, March, April, May, July, September, October and November. The main aim of the journal is to publish high quality, peer-reviewed papers that relate to all branches of surgery.

    The Annals also includes letters and comments, a regular technical section, NICE news, controversial topics, CORESS feedback, book reviews and the best trainee presentations from England and Wales. The editorial board is composed of members of the College Council and experts from across the surgical specialties.

    Archive issues of the Annals of The Royal College of Surgeons of England are available via the PubMed Central database

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