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Approach to Hemorrhoids

  • Large Intestine (B Cash, Section Editor)
  • Published:
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Abstract

Hemorrhoids are a very common anorectal disorder defined as the symptomatic enlargement and abnormally downward displacement of anal cushions. The current pathophysiologies of hemorrhoids include the degenerative change of supportive tissue within the anal cushions, vascular hyperplasia, and hyperperfusion of hemorrhoidal plexus. Low-grade hemorrhoids are easily and effectively treated with dietary and lifestyle modification, medical intervention, and some office-based procedures. An operation is usually indicated in symptomatic high-grade and/or complicated hemorrhoids. Whilst hemorrhoidectomy has been the mainstay of surgical treatment, more recently other approaches have been employed including Ligasure hemorrhoidectomy, stapled hemorrhoidopexy, and doppler-guided hemorrhoidal artery ligation. Post-procedural pain and disease recurrence remain the most challenging problems in the treatment of hemorrhoids. This article deals with modern approaches to hemorrhoids based on the latest evidence and reviews of the literature. The management of hemorrhoids in complicated situations is also discussed.

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Conflict of Interest

Varut Lohsiriwat declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand

    Varut Lohsiriwat

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  1. Varut Lohsiriwat
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Correspondence to Varut Lohsiriwat.

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This article is part of the Topical Collection on Large Intestine

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Lohsiriwat, V. Approach to Hemorrhoids. Curr Gastroenterol Rep 15, 332 (2013). https://doi.org/10.1007/s11894-013-0332-6

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  • DOI: https://doi.org/10.1007/s11894-013-0332-6

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