• Francis Seow-Choen
  • Kok-Yang Tan
Reference work entry

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...


Anal Canal High Fiber Diet Staple Hemorrhoidopexy Rubber Band Ligation Suspensory Ligament 
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Selected Readings

  1. Ho YH, Tan M, Seow-Choen F, Goh HS (2000) Micronized purified flavonidic fraction compared favorably with rubber band ligation and fiber alone in the management of bleeding hemorrhoids. Randomized controlled trial. Dis Colon Rectum 43:66–68PubMedCrossRefGoogle Scholar
  2. Lloyd D, Ho KS, Seow-Choen F (2002) Modified Longo’s hemorrhoidectomy. Dis Colon Rectum 45:416–417PubMedCrossRefGoogle Scholar
  3. Ng KH, Ho KS, Ooi BS, et al. (2006) Experience of 3711 stapled hemorrhoidectomy operations. Br J Surg 93:226–230PubMedCrossRefGoogle Scholar
  4. Seow-Choen F (2002) Surgery for hemorrhoids: ablation or correction. Asian J Surg 25:265–266PubMedCrossRefGoogle Scholar
  5. Tan KY, Sng KK, Tay KH, et al. (2006) Randomized double blind clinical trial 0.2 percent glyceryl trinitrate ointment on wound healing and pain reduction after open diathermy hemorrhoidectomy. Br J Surg 93:1464–1468PubMedCrossRefGoogle Scholar
  6. Thomson WHG (1975) The nature of hemorrhoids. Br J Surg 62:542–552PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Francis Seow-Choen
  • Kok-Yang Tan

There are no affiliations available

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