Is hemorrhoidal surgery really unsafe in inflammatory bowel disease? Results from the HEAD-IBD multicenter study on behalf of IG-IBD.

Authors

C Felice, D Pugliese, G Gallo, G L Di Tanna, M Ascolani, G S Sica, V Bellato, M Franco, F Scaldaferri, L Parisio, F Colombo, A Bondurri, C Guerci, A Aratari, S Festa, F Ascari, E V Savarino, U Grossi

Published in

Techniques in coloproctology. Volume 30. Issue 1. Jul 26, 2026. Epub Jul 26, 2026.

Abstract

Surgical management of hemorrhoidal disease (HD) in patients with IBD remains controversial because of concerns about impaired outcomes. This study aimed to evaluate the safety and IBD-related outcomes of surgical treatments for HD in patients with IBD and to explore factors potentially associated with postoperative complications and IBD flare.
HEAD-IBD is a retrospective cohort study promoted by the Italian Group for the study of IBD (IG-IBD). Adults with established ulcerative colitis (UC) or Crohn's disease (CD) who underwent surgery for HD between 2004 and 2024 and had at least 12 months of follow-up were included. Surgical techniques, 1-, 6-, and 12-month complications, IBD flares (6 months), new onset perianal disease, and continence outcomes were analyzed.
A total of 38 patients were included (21 UC, 17 CD), 55% male. Clinically active disease at the last gastroenterology visit prior to surgery was present in 24% of UC and 41% of patients with CD. Open excisional hemorrhoidectomy was the most frequently performed procedure in both groups (66% UC, 73% CD), while non-excisional techniques were used in approximately one-third of cases. No 30-day or 6-month surgical complications occurred in patients with CD. Postoperative surgical complications were observed exclusively in patients with UC (5/21, 24%) and were mostly mild. Within 6 months after surgery, IBD flares occurred in 6 patients (16%), proportionally comparable between CD and UC. During overall follow-up, new-onset perianal disease developed in 5 patients (13%), predominantly in CD (4/5 cases), while new-onset incontinence was observed in 2 (5%) patients, both managed conservatively.
In this largest European multicenter cohort, surgical treatment of HD in IBD was associated with low morbidity and preservation of anorectal function. These findings support a more individualized approach and underscore the need for prospective studies.

PMID:
42907681
Bibliographic data and abstract were imported from PubMed on 23 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.