Causes of granulation after hemorrhoid surgery

As the saying goes, nine out of ten men and ten out of ten women have hemorrhoids. This shows that the incidence of hemorrhoids is still very high. Hemorrhoids have a great impact on people. If they are serious, surgery is required to cure them. However, after hemorrhoid surgery, various problems may arise, such as granulation of the wound. So, why does granulation tissue grow after hemorrhoid surgery? Here we will introduce the causes and prevention methods of granulation after hemorrhoid surgery.

1. What causes granuloma?

1. Tumor-like theory

It resembles reticulum cell sarcoma or lymphoma, with neoplastic proliferation of atypical cells and mitotic figures, but without necrotic blood vessels and multinucleated giant cells. The disease is limited to the nose and respiratory tract. In the late stage of the disease, various parts of the body such as internal organs, lymph nodes and bone marrow may show the same lesions, so it is very similar to the metastasis of malignant tumors. Some patients can be cured by radiotherapy, which is consistent with the tumor theory.

2. Allergic reaction or autoimmunity

Immunoglobulins are deposited in the capillary walls and immune complexes appear in the serum of patients during the active phase of the disease. They disappear when symptoms are relieved by immunosuppressant treatment. Immunofluorescence tests revealed C3 and IgG in the basal membrane of the glomeruli. Electron microscopy showed coarse granular substances like immune complexes in the basement membrane, and the level of ring immune complexes was elevated; both are autoimmune diseases.

3. Bacterial and viral infection theory

Recent studies have found bacteria and virus bodies in cell cultures of granuloma tissue and in patient serum, so it is believed to be related to bacterial and viral infection.

Types of granulomas

Infectious granuloma refers to granuloma caused by infection with biological pathogens (bacteria, Treponema pallidum, fungi, parasites, etc.). Can form cell nodules with special structures.

Foreign body granuloma refers to a granuloma caused by foreign bodies (surgical sutures, dust, talcum powder, wood splinters, etc.). The lesion is centered on the foreign body and is surrounded by a large number of macrophages, foregin body giant cells, fibroblasts and lymphocytes, forming a nodular lesion.

Sarcoid granulomas are non-necrotizing epithelioid cell granulomas that occur in sarcoidosis. Sarcoidosis is a systemic disease of unknown etiology. The granuloma was mainly composed of epithelioid cells, multinucleated giant cells, and lymphocytes, without caseous necrosis.

3. How to prevent

1. Strengthen nutrition and enhance physical fitness.

2. Prevent and control infection and improve autoimmune function.

3. Avoid wind, cold and dampness, avoid excessive fatigue, avoid smoking and drinking, and avoid eating spicy food.

Early diagnosis, understanding of the infection situation, clinical observation, early detection of damage to various systems, early treatment, and mainly control of infection.