الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Haemorrhoids are a very popular disease. Approximately 50% to 66% of people have problems with haemorrhoids at some point in their lives. (Lorenzo-Rivero, 2009).Haemorrhoids are found in the anal canal, so you should be aware of the anatomy of the anal canal which is the last portion of the rectum and is about 3-4 cm long.
The pathophysiology of haemorrhoids is not exactly well known. Theories were developed to try to understand the pathophysiology of haemorrhoids e.g., varicose vein theory, anal lining sliding theory, hyperactivity of internal sphincter theory and vascular hyperplasia theory.
Diagnosis is made by integration of available clinical data (symptoms), clinical examination and investigations. And treatment of haemorrhoids ranges from dietary and lifestyle modification to radical surgery, depending on the degree of haemorrhoids and severity of symptoms. Surgery is the most popular chosen modality of treatment. Pain is the most important complications after haemorrhoidal surgeries.
Although most causes of anal pain are benign, the pain itself can be severe because of the many nerve endings in the perianal region. Many conditions that cause anal pain may also cause rectal bleeding, which is usually more frightening than serious. Accurate assessment of acute pain is very important for the development of an effective pain management plan. Pain assessment is difficult because of the subjectivity and multidimensionality of the pain experience. Pain scales are the best way to communicate with the patient to assess his pain.
Metronidazole is the scientific name of an antibiotic which is known as flagyl in the market. It is used mainly for anaerobes and is effective also against protozoa. It can be used alone or as a combination with other antibiotics.
Bacteria are known to colonise haemorrhoidectomy wounds, and some investigators postulate that this colonization may lead to secondary infection and could be one of the factors responsible for postoperative pain. It has therefore been suggested that metronidazole could decrease postoperative pain after haemorrhoidectomy.
This thesis study was done to assess the efficacy of oral metronidazole administration in management of post haemorrhoidectomy pain. This study was conducted at El Demerdash hospital and Damanhur National Institute in 1/1/2018 to 30/6/2018 and it was ended up to that oral metronidazole administration do decrease the pain post haemorrhoidectomy and reduce the need to more post-operative analgesics with no effect on pain at day 7 or the time of the first.