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Had a PPH done for Hemorrhoids. Still feels weak, losing weight. What is it? Go over surgery?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
I live in China and last Saturday my Chinese roommate went to the doctor because of some pain. She had a PPH done for Hemorrhoids almost 1 month ago and still is having problems. She feels very weak and often feels very full very fast so she has lost alot of weight, though she was very thin to begin with. She went to another hospital and had some tests ran. I have posted the results below as best as I could translate. The doctor said there was some kind of problem, but he would have to do some kind of surgery to find out. I was wondering if by looking at these results, you could offer some advice as to what she needs to do.

1     color     light yellow          
2     turbidity     clear               
3     PH     5.5          5.4-8.4     
4     Proportion     1.021          1.003-1.030
5     Enzymes     Gram negative     -          
6     Nitrate     Gram negative     -          
7     Sugar     Gram negative     -          
8     Protein     Gram negative     -          
9     Ketone     Gram negative     -          
10     Gallbladder     Gram negative     -          
11     Gallbladder     Gram negative     -          
12     Fecal blood     Gram negative     2+          
13     White blood cells     6.4          0-36.0     
14     Red blood cells     4.3          0-27.0     
15     BC     18.2          0-40.0     
16     CAST     0.24          0-1.0     
17     BACT     424.9          0-500     
18     Erythrocyte red blood cell #     3               
19     Erythrocyte red blood cell %     69.4               
20     Electrical conductivity     3.01          5.0-38     
21     WBC     Gram negative     -          
22     RBC     Gram negative     -          
1     PH     5.5               
2     protein          -          
3     Erthrocyte; red blood cell     0          <8,000     
4     Erthrocyte; red blood cell     1000          <8,000     
1     TP     78.3          64-87     
2     ALB     44.5          35-50     
3     GLB     33.8          20-32     
4     White ratio     1.3          1.4-2.5     
5     PA     139          200-400     
6     TBIL     7          3-     22
7     DBIL     1          0.5-7     
8     IBIL     6          3-     15
9     TBA     1.7          0.1-10     
1     ALT     12          1-     40
2     AST     17          1-     37
3     GGT     15          2-     50
4     LDH     135          114-240     
5     ALP     46          0-110     
6     CHE     7495          5300-0000
7     LAP     45          30-70     
8     GLDB     0.8          0.1-7.5     

Posted Wed, 23 May 2012 in General Health
Answered by Dr. Ketan Vagholkar 1 hour later

I could partly understand the reports although the translation is not perfect to give a solid opinion.

From the reports it appears that she is still loosing blood from the anal opening.

If your friend is my patient I do not consider to operate immediately. She requires a proper per rectal and proctoscopic examination to look for the persistent cause for symptoms. If that is equivocal then even a sigmoidoscpic evaluation may be necessary. Only thereafter a decision can be taken as to what are the further options.

It is important for her to continue the stool loosening medication, eat high fibre diet, visit loo regularly further options. She can request for pain medications with the doctor for better quality of life.

Let me know if you have further queries.

With regards.
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