Improvement in quality of life among Sri Lankan patients with haemorrhoids after invasive treatment: a longitudinal observational study

Abstract

Background Haemorrhoids is a common chronic disease that can significantly impact patients’ quality of life. Yet, few studies have evaluated health-related quality of life (HRQoL) of patients with haemorrhoids before and after treatment. This study investigated the HRQoL of patients with haemorrhoids before and after treatment and the change in HRQoL from baseline. Methods A prospective observational study of patients with haemorrhoids was conducted at two public hospitals in Kandy, Sri Lanka. Two questionnaires assessing symptom severity and haemorrhoid-specific QoL were administered at initial consultation and at 4- and 8-week follow-ups after treatment (sclerotherapy, rubber band ligation (RBL), haemorrhoidectomy or evacuation of haematoma). The primary outcome was the least squares (LS) change of HRQoL score from baseline, measured using the Short Health Scale adapted for Haemorrhoidal Disease (4 domains: symptom load, interference with daily activities, concern, general well-being). Results In 48 patients selected for this study, LS mean change from baseline showed significant improvement in HRQoL across all domains and total Short Health Scale adapted for Haemorrhoidal Disease score at 4- and 8-week follow-ups ( P < 0.001). Difference in LS mean change from baseline also showed continued improvement of HRQoL from week 4 to week 8 ( P < 0.010). ‘Concern’ showed greatest improvement at 4 and 8 weeks ( P < 0.001). Averaged LS mean changes from baseline showed RBL had greater improvement of HRQoL compared with sclerotherapy ( P = 0.004). Conclusion Patients with haemorrhoids had improved HRQoL after invasive treatment. Haemorrhoid-specific QoL is an important component of the extent of disease and can serve as an aid to guide treatment, assess outcomes and monitor disease.

Evaluation of the Farsi‐translated Hemorrhoidal Disease Symptom Score and Short Health Scale questionnaires in patients with hemorrhoid disease: A cross‐sectional study

“…A simple translation of the questionnaire without any modification for cultural and linguistic context can result in an inaccurate measurement. According to our results the farsi translated HDSS and HSS questionaaires show both reliability and accuracy 7,10,18,26 …”

“…According to our results the farsi translated HDSS and HSS questionaaires show both reliability and accuracy. 7,10,18,26 In a recent study, the COSMIN criterion was used to evaluate the methodological quality of both HDSS and HSS, which concluded that both tests exhibit acceptable qualities for evaluation and scoring. Future research in this field should include additional tests and evaluations utilizing both COSMIN criteria and a gold standard criterion for hemorrhoidal disease, with both English and Farsi versions.…”

“…Various factors, including constipation, prolonged straining, exercise, pregnancy, obesity, aging, genetics, increased intra‐abdominal pressure, valves absence within the hemorrhoidal veins, and nutrition, can lead to pathologic changes in hemorrhoid cushions and induce hemorrhoidal disease 4,5 . The most common complaints of patients suffering from the hemorrhoidal disease are bleeding, itching, soiling, prolapse, and pain 6‐10 …”

“…4,5 The most common complaints of patients suffering from the hemorrhoidal disease are bleeding, itching, soiling, prolapse, and pain. [6][7][8][9][10] Since many cases are asymptomatic and many symptomatic cases have a propensity for self-medication, the actual prevalence of hemorrhoidal disease (HD) remains unknown. 3,11,12 Nevertheless, the prevalence of hemorrhoids is reported to be 4.4% in the United States, 11% in Spain, 14.4% in Korea, 16% in Italy, and 38.93% in Austria.…”

Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids: A retrospective study

“…In a longitudinal observational study, bleeding and soiling showed significant improvements in symptom severity from weeks 4 to 8 post-surgery, whereas pain, itching, and swelling/prolapse did not[ 15 ]. This difference in the improvement of specific symptoms may be attributed to the surgical techniques used.…”