The importance of pain, pruritus and soiling as symptoms of haemorrhoids and their response to haemorrhoidectomy or rubber band ligation

Bowel habit, anal pain or discomfort, pruritus ani and faecal soiling have been assessed in 82 patients with uncomplicated, prolapsing haemorrhoids before and after successful treatment (improvement in rectal bleeding and haemorrhoidal prolapse) by haemorrhoidectomy or rubber band ligation. An age and sex-matched control group of patients without haemorrhoids was similarly assessed. The bowel habit of the haemorrhoid group was not different from that of the control population. Pain or discomfort, pruritus and faecal soiling were much commoner in the pretreatment haemorrhoid group, compared to controls. Treatments designed to abolish rectal bleeding and prolapse (the cardinal symptoms of haemorrhoids) also reduced the incidence of these three symptoms. Only anal pain or discomfort, however, was reduced to the incidence found in the control group. Haemorrhoidectomy and rubber band ligation appeared equally effective in controlling all three symptoms. It is concluded that anal pain or discomfort, pruritus ani and faecal soiling are common symptoms of uncomplicated haemorrhoids and that they are abolished in the majority of patients by successful treatment for rectal bleeding and haemorrhoidal prolapse.