Management of Internal Hemorrhoidal Disease by Elastic Ligation in Ouagadougou, Burkina Faso

Introduction: Hemorrhoidal disease is the leading cause of proctology consultations. The management of internal hemorrhoids can be medical, instrumental, and surgical. Instrumental treatment is a recent practice in Burkina Faso. The aim of our study was to evaluate rubber band ligation of hemorrhoids in Burkina Faso. Patients and method: This was a descriptive case series study with retrospective data collection. It took place from January 1, 2021 to April 30, 2023 at the ILBOUDO BRUNO clinic. All patients with internal hemorrhoidal disease, who had undergone hemorrhoid ligation, with a usable medical record and a valid telephone contact, were included. Results: A total of 107 patients underwent rubber band ligation. The mean age of the patients was 42.8 years ± 13.16 years. The sex ratio was 3.1. The patients resided in Ouagadougou at 84.1%. Hematochezia was the dominant symptom (83.2%). Hemorrhoidal prolapse was grade II (23.3%) and grade III (15%). An anal fissure was associated in 6.5% of patients. A ligation session was performed in 49 patients compared to 2 to 4 sessions for the other 58. The number of hemorrhoidal bundles treated per session varied from 2 to 3. Elastic ligation of hemorrhoids was effective for 86.5% of hematochezias and for 73.2% of hemorrhoidal prolapses. Immediate complications were observed in 7.5% of cases, such as anal pain. Fifteen patients experienced a recurrence, or 14%, within a period of 3 to 6 months. Conclusion: Rubber band ligation is an effective technique. It must find a place and an indication here before surgery. It must be developed and made accessible to patients in Burkina Faso.