Related Experiment Video
Updated: Jan 5, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Excisional Hemorrhoidectomy: Safe in Patients With Crohn's Disease?
Amy L Lightner1, David Kearney1, Danica Giugliano1
1Department of Colorectal Surgery, Digestive Disease Surgical Institute, Cleveland Clinic, Cleveland, OH.
Insights
Excisional hemorrhoidectomy is safe and effective for Crohn's disease (CD) patients with symptomatic hemorrhoids who failed nonoperative treatments. This surgical option avoids new perianal disease or proctectomy in CD patients.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Inflammatory Bowel Disease
Background:
- Hemorrhoidectomy in Crohn's disease (CD) patients is controversial due to wound healing concerns.
- Hemorrhoidal disease is prevalent among individuals with CD.
Purpose of the Study:
- To evaluate the safety and efficacy of excisional hemorrhoidectomy in patients with Crohn's disease.
- To assess postoperative complications and long-term outcomes following hemorrhoidectomy in CD patients.
Main Methods:
- Retrospective review of adult CD patients undergoing excisional hemorrhoidectomy from 1995-2019 at two IBD referral centers.
- Data collection included patient demographics, CD characteristics, and postoperative complications (bleeding, wound healing, need for further intervention).
Main Results:
- 36 CD patients with symptomatic hemorrhoids underwent hemorrhoidectomy.
- 11% complication rate observed, including stricture, abscess/fistula, nonhealing wound, and recurrence.
- Median follow-up was 31.5 months.
Conclusions:
- Excisional hemorrhoidectomy can be safely performed in CD patients who have not responded to nonoperative hemorrhoid treatment.
- The procedure does not appear to cause new perianal disease or necessitate proctectomy in this patient group.
Introduction:
Due to concerns over wound healing, hemorrhoidectomy in patients with Crohn's disease (CD) remains controversial. We sought to ascertain safety and efficacy of excisional hemorrhoidectomy in CD.
Methods:
A retrospective review of all adult CD patients undergoing excisional hemorrhoidectomy between January 1, 1995, and January 1, 2019, at 2 IBD referral centers was performed. Data collected included patient demographics, clinical characteristics of CD (anorectal symptoms; prior nonoperative hemorrhoidal therapy; presence of other perianal disease; and activity, duration, and anatomic location of CD), and postoperative complications including bleeding, wound healing, and need for further therapy or surgical intervention after surgery.
Results:
A total of 36 adult patients with Crohn's disease with symptomatic hemorrhoidal disease were included. The study cohort included 16 males (44%), and median age was 49 (range, 21 to 77) years. Predominant symptoms included pain (n = 16; 44%), prolapse (n = 8; 22%), and bleeding (n = 12; 33%). Sixteen patients (44%) had nonoperative therapy before surgery. Twenty-four patients (67%) had other perianal disease. At the time of hemorrhoidectomy, 9 patients (25%) were exposed to corticosteroids, 8 patients (25%) to immunomodulators, and 9 patients (25%) to biologics. During a median follow-up time of 31.5 (range, 1 to 255) months after hemorrhoidectomy, 4 patients (11%) had complications (1 developed a stricture, 1 developed a perianal abscess/fistula, 1 had a nonhealing wound, and 1 had hemorrhoidal recurrence).
Conclusion:
Our data suggest that excisional hemorrhoidectomy may be performed safely in CD patients who have failed nonoperative hemorrhoidal therapy without concern for de novo perianal disease or need for proctectomy.Hemorrhoidal disease is common in patients with Crohn's disease. This study sought to understand the outcomes of surgically treating hemorrhoids in patients with Crohn's disease.
More Related Videos
08:26Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
07:22Surgical Robot-Assisted Transanal Specimen Extraction Radical Sigmoidectomy Without an Auxiliary Abdominal Incision
Published on: June 13, 2025
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids