Haemorrhoidectomy and disordered rectal and anal physiology in patients with prolapsed haemorrhoids

The effect of haemorrhoidectomy on rectal and anal physiological abnormalities was studied in 24 consecutive patients (12 men and 12 women of mean (s.e.m.) age 39.1 (2.4) years) and compared with results in 13 sex- and age-matched controls. Before operation those with haemorrhoids had significantly higher resting anal pressures (P < 0.005), lower rectal compliance (P < 0.05) and more perineal descent (P < 0.05). Following haemorrhoidectomy there were significant decreases in the maximum resting (P < 0.05) and maximum squeeze anal (P < 0.001) pressures to within normal values 3 months after operation. Rectal compliance also increased significantly (P < 0.05), to that of normal controls. The abnormalities found in patients with prolapsed piles reverted to the normal range within 3 months of haemorrhoidectomy. These physiological changes are therefore more likely to be an effect, rather than the cause, of enlarged anal cushions.