Large rectal polyp with haemorrhoidal disease Elective polypectomy

Hello,

Managing Large Rectal Polyps with Haemorrhoidal Disease

Managing a large rectal polyp alongside haemorrhoidal disease requires a careful and personalized approach, depending on the size, type, and symptoms of both conditions.

Understanding Large Rectal Polyps

• Large polyps (especially >2 cm) can be challenging due to their size, flat shape (sessile), or location near the anal canal.

• Risks include bleeding, incomplete removal, and in rare cases, potential precancerous changes.

Treatment Options for Polyps

1. Endoscopic Mucosal Resection (EMR)
   A solution is injected beneath the polyp to lift it before removal. Often used for larger but benign polyps. May need multiple sessions.

2. Endoscopic Submucosal Dissection (ESD)
   Advanced method allowing full single-piece removal. Reduces recurrence risk but needs an expert surgeon.

3. Transanal Endoscopic Microsurgery (TEMS)
   Minimally invasive surgery through the anal canal for polyps not easily accessible by endoscope.

4. Surgical Resection
   Required if the polyp is cancerous or too complex for endoscopic removal. May involve part of the rectum being removed.

Understanding Haemorrhoidal Disease

• Haemorrhoids are swollen blood vessels in the anal canal, often causing pain, bleeding, itching, or prolapse.

• Can worsen due to chronic constipation, straining, or prolonged sitting.

Treatment Options for Hemorrhoids:

• Lifestyle & Medical: High-fiber diet, warm water sitz baths, ointments, and stool softeners.

• Minimally Invasive: Rubber band ligation, infrared coagulation.

• Surgical: Hemorrhoidectomy or stapled hemorrhoidopexy (in severe cases).

Risks and Considerations (Both Conditions)

• Bleeding: Especially after polyp or hemorrhoid removal.

• Perforation: Rare but serious risk during large polyp resection.

• Incomplete Treatment: May need staged or multiple procedures for complete management.

• Co-management: Symptoms from hemorrhoids can worsen during recovery if not addressed simultaneously.

Next Steps

1. Consultation: Meet a colorectal surgeon or gastroenterologist experienced in both polypectomy and hemorrhoid management.

2. Evaluation: You may need colonoscopy, endorectal ultrasound, or MRI to assess the full extent of both problems.

3. Combined Treatment Planning: In some cases, both conditions can be treated in one procedure. The decision depends on your overall health and anatomy.

4. Recovery and Follow-Up: Healing varies by procedure type. Follow-up is essential to monitor healing and prevent recurrence.

If you need help finding a qualified specialist or an Ayushman Bharat empanelled hospital for treatment support, feel free to ask. Wishing you the best for a complete and speedy recovery.