Hemorrhoids: associated pathologic conditions in a family practice population

Area of Science:

• Gastroenterology
• Colorectal Surgery

Background:

• Hemorrhoidal disease often co-occurs with other anorectal conditions in referral settings.
• Aggressive diagnostic procedures are recommended for associated pathologies.
• Patient and physician procrastination in management is common.

Purpose of the Study:

• To determine if general population patients with hemorrhoids face a high risk of significant anorectal disease.
• To evaluate the necessity of aggressive diagnostic measures in unselected hemorrhoid patients.

Main Methods:

• Retrospective chart review of 173 patients diagnosed with hemorrhoids from a nonselected population.
• Analysis of treatment management, coexisting anorectal diseases, and sequelae.

Main Results:

• A small subset of patients over 55 years old showed a potential increased risk for colon polyps.
• Diagnostic tests like anoscopy, barium enema, fecal occult blood testing, and CBC yielded low diagnostic value.
• Findings contrast with data from selected populations where hemorrhoids rarely occur in isolation.

Conclusions:

• Family physicians appear to manage hemorrhoidal disease appropriately in the general population.
• Clinical evaluation of hemorrhoids should be guided by symptoms, signs, and age-specific cancer screening guidelines.