Modern management of hemorrhoidal disease

Gastroenterol Clin North Am. 2013 Dec;42(4):759-72. doi: 10.1016/j.gtc.2013.09.001. Epub 2013 Oct 23.

Abstract

Complaints secondary to hemorrhoidal disease have been treated by health care providers for centuries. Most symptoms referable to hemorrhoidal disease can be managed nonoperatively. When symptoms do not respond to medical therapy, procedural intervention is recommended. Surgical hemorrhoidectomy is usually reserved for patients who are refractory to or unable to tolerate office procedures. This article reviews the pathophysiology of hemorrhoidal disease and the most commonly used techniques for the nonoperative and operative palliation of hemorrhoidal complaints.

Keywords: External hemorrhoids; Hemorrhoidectomy; Hemorrhoids; Internal hemorrhoids; Nonoperative management; Prolapsing hemorrhoids; Thrombosed hemorrhoids.

Publication types

  • Review

MeSH terms

  • Administration, Topical
  • Calcium Dobesilate / therapeutic use
  • Cryotherapy / methods
  • Diet Therapy / methods
  • Dietary Fiber / therapeutic use*
  • Drinking
  • Flavins / therapeutic use
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy
  • Hemorrhoidectomy / methods
  • Hemorrhoids / complications
  • Hemorrhoids / therapy*
  • Hemostatics / therapeutic use*
  • Humans
  • Ligation / methods
  • Rectal Diseases / etiology
  • Rectal Diseases / therapy
  • Sclerotherapy / methods
  • Surgery, Computer-Assisted / methods
  • Ultrasonography, Doppler
  • Vasoconstrictor Agents / therapeutic use*

Substances

  • Dietary Fiber
  • Flavins
  • Hemostatics
  • Vasoconstrictor Agents
  • Calcium Dobesilate