Re: esophageal cancer and hemorrhoids

Posted By HFHSM.D.-ym on August 14, 1998 at 11:37:15:

In Reply to: esophageal cancer and hemorrhoids posted by ann on August 13, 1998 at 21:27:53:






My relative had successful surgery for esophageal cancer and his stomach was reconstructed and made smaller.  This was eight months ago and he has been seriously plagued with hemorrhoids since then.  He had problems with them before the surgery, but since the surgery they have gotten much worse.  He has frequent bowel movements throughout the day.  Are the hemorrhoids related to the surgery?  Would there be any follow up infection causing them?  In the past he had some surgery for the hemorrhoids but they have come back.. What is the recommended treatment for them at this stage? Thank you.
Dear Ann,
Im glad to hear that your relative has done so well post-operatively. It is very difficult to find a direct connection between the esophageal cancer operation and exacerbation of hemorrhoidal disease. Hemorrhoids, on the other hand, contrary to popular belief, have not been proven to be associated with chronic constipation. They are associated with diarrhea and frequent, loose bowel movements. I would recommend that your relative have an evaluation to determine the cause of his diarrhea. One possibility (since you connect the development of loose bowel movements to his surgery) is that the diarrhea is due to damage to the vagus nerve (in order to mobilize the stomach during the operation, a surgeon may need to cut branches of the vagus nerve) during the operation. Post-vagotomy diarrhea and steatorrhea (fat malabsorption) is usually treated with anti-diarrheal agents such as codeine, loperamide or bile acid resin binders such as cholestyramine or the calcium channel blocker verapamil (with or without cholestyramine) taken one hour before meals. These medications are only available by prescription. It would also be important to rule out other causes of diarrhea such as infections, drug-induced etc. Treating the underlying cause of the diarrhea will probably improve the hemorrhoids. If not, another option is to consult a colorectal surgeon for further intervention.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Szilagy, one of our expert Colorectal Surgeons.
HFHSM.D.-ym
*Keywords: hemorrhoids, diarrhea, post-vagotomy diarrhea, esophageal cancer