[Haemorrhoidal disease]

Hemorrhoids are normal component of anal canal anatomy, potential factors such as heredity rend them symptomatic. Hemorrhoidal disease is more or less severe, but always remains benign. It is a frequent affection: almost half of the French population suffers once a year from benign anorectal symptoms, including hemorrhoidal. Only 20% visit a medical doctor. Diagnosis is clinical and always set up after having ruled out another locoregional pathology. Colonoscopy indication should be large, but not abusive. First intention local and systemic medical treatment has proved their efficay. To unsatisfied patients, instrumental or surgical treatment may be offered. Instrumental treatment exposes to rare complications, and results are modest, deteriorating with time. Severe symptoms in a patient asking for the most efficacious technique, may lead to surgery. Surgery morbidity has decreased, due to less aggressive surgical dissection, innovations in procedures and instrumentation.