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Classification and guidelines of hemorrhoidal disease: Present and future
Michele Rubbini1, Simona Ascanelli2
1Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara 44121, Italy. rbb@unife.it.
Insights
Current hemorrhoidal disease classifications show contradictions. This study proposes a new classification and guideline to better guide treatment by considering prolapse, symptoms, and patient factors.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Medical Guidelines
Background:
- Hemorrhoidal disease classification relies on prolapse grades, influencing treatment choices.
- Existing classifications and guidelines from scientific societies present contradictions and limitations.
- These limitations hinder the selection of optimal treatment strategies for hemorrhoidal disease.
Abstract:
Classification and guidelines of hemorrhoidal disease are based on the subdivision in Grades of prolapse followed by any aspect related to both the treatment and its technique. When taking the proposals for classification and guidelines issued by prolific scientific societies into consideration, it is evident that strong contradictions and interpretative limits emerge in finding the best treatment to be adopted. After a critical examination of these limitations, a methodological proposal is shared to achieve a new classification, which plays a part in forming a new guideline for hemorrhoidal disease, identifying its evolution, dynamism of the prolapse, symptomatology, enteropathogenesis and gender characteristics.
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