Pearls and Pitfalls
Hemorrhoidal tissue is a normal anatomical structure that is only of concern when symptomatic.
Factors predisposing to hemorrhoids include: hereditary factors, straining during defecation, squatting during defecation, and pregnancy.
Use of a high fiber diet is controversial and may aggravate symptoms.
Other sinister colorectal conditions may mimic hemorrhoid symptoms.
Only symptomatic hemorrhoids require treatment.
Hemorrhoids are traditionally divided into 4 degrees. Each degree should, however, be subdivided into large and small piles.
Some small fourth-degree hemorrhoids may be treated conservatively, however, large first-degree piles may require operative intervention.
Single pedicle rubber band ligation is efficacious and superior to injection sclerotherapy.
Stapled hemorrhoidopexy is efficacious in most patients that require operative intervention.
Patients with filiform skin tags or singular hemorrhoid prolapse should be treated with conventional operative...