HEMORRHOID DISEASE: DIAGNOSIS TREATMENT AND COMPLICATION MANAGEMENT

Hemorrhoidal_Disease_Bahadir_Egekapak

HEMORRHOIDAL DISEASE IN TRANSPLANT PATIENTS

Ulaş Sözener

Atılım University, Faculty of Medicine, Department of General Surgery, Ankara, Türkiye

Sözener u. Hemorrhoidal Disease in Transplant Patients. In: Ege B, editor. Hemorrhoidal Disease: Diagnosis, Treatment and Complication Management. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.135-138.

ABSTRACT

Hemorrhoidal disease (HD) presents unique challenges in transplant patients, a group with specific risk factors due to immunosuppressive therapy and other post-transplant complications. While the general population experiences a prevalence of 4.4% for hemorrhoidal disease, transplant recipients show a significantly higher incidence, with approximately 20% of patients developing hemorrhoidal symptoms post-transplantation. Several mechanisms contribute to this increased risk, including immunosuppressive therapy, corticosteroid-induced weight gain, gastrointestinal side effects of medications, and potential viral infections such as cytomegalovirus (CMv). The management of HD in transplant patients typically begins with conservative, non-surgical approaches such as dietary changes, stool-bulking agents, and topical therapies. However, more invasive treatments, including hemorrhoidectomy, are generally avoided due to increased risks of poor wound healing and infection. Injection sclerotherapy may offer a safer alternative for patients with refractory bleeding. Given the immunocompromised status of these patients, careful assessment of immunosuppression levels and close monitoring are essential. This review emphasizes the importance of early detection, appropriate management strategies, and patient education to address the unique challenges in managing hemorrhoidal disease in transplant recipients.

Keywords: Hemorrhoids; Conservative treatment; Bleeding; Organ transplantation; Immunosuppressive agents

Referanslar

  1. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology. 1990;98(2):380-6. [Crossref]  [PubMed]
  2. Thomson WH. The nature of haemorrhoids. Br J Surg. 1975;62(7):542-52. [Crossref]  [PubMed]
  3. Khosravi M, Nobakht A, Nikokar AR. Cytomegalovirus disease with atypical presentation in a renal transplant patient: case report. Exp Clin Transplant. 2006;4(1):458-61. [PubMed]
  4. Tallarita T, Gurrieri C, Cappellani A, Corona D, Gagliano M, Giuffrida G, et al. Clinical features of hemorrhoidal disease in renal transplant recipients. Transplant Proc. 2010;42(4):1171-3. [Crossref]  [PubMed]
  5. Scaglia M, Delaini GG, Destefano I, Hultén L. Injection treatment of hemorrhoids in patients with acquired immunodeficiency syndrome. Dis Colon Rectum. 2001;44(3):401-4. [Crossref]  [PubMed]