Purpose of Review
Hemorrhoid disease is extremely common, and seldom requires surgical intervention. The vast majority of patients can be cared for in the office setting and by the gastroenterologist. This piece aims to summarize the epidemiology and pathophysiology of hemorrhoid disease, along with the proper evaluation and office-based treatment of these patients.
Most GI fellowship training programs spend little time on these topics, and the recommendation has been made to include anorectal care in the GI’s “core curriculum.” The use of the anoscope and a proper anorectal examination are keys to evaluating these patients, and the techniques available to treat these patients are described. Often overlooked in these patients are other anorectal issues that occur alongside hemorrhoidal issues very commonly—the most common being anal fissure. Comprehensive management of all of these issues will allow all but the most severely affected patients to avoid the expense and morbidity of surgical intervention.
The anatomy, etiology, pathophysiology, diagnosis, and non-surgical treatment of hemorrhoid disease are presented with the gastroenterologist in mind.
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Conflict of Interest
Mitchel Guttenplan is the medical director for CRH Medical and holds a patent for an upgrade of a device for CRH Manufacturers (the device itself is not mentioned in this paper).
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by the author.
This article is part of the Topical Collection on Large Intestine
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Guttenplan, M. The Evaluation and Office Management of Hemorrhoids for the Gastroenterologist. Curr Gastroenterol Rep 19, 30 (2017). https://doi.org/10.1007/s11894-017-0574-9