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Belgian consensus guideline on the management of hemorrhoidal disease

H De Schepper1, G Coremans2, M A Denis3

  • 1Department of Gastroenterology and Hepatology, University Hospital Antwerp, Belgium.

Acta Gastro-Enterologica Belgica
|February 28, 2021
PubMed

Insights

Hemorrhoidal disease management guidelines offer tailored treatment strategies for various grades of hemorrhoids, from conservative fiber supplements to surgical interventions like hemorrhoidectomy for severe cases.

Area of Science:

  • Gastroenterology and Colorectal Surgery
  • Medical Guidelines and Consensus

Background:

  • Hemorrhoidal disease is prevalent, characterized by engorged or prolapsed anal canal structures.
  • Current treatment guidance for hemorrhoidal disease is insufficient, despite diverse conservative and invasive options.

Purpose of the Study:

  • To establish evidence-based guidelines for the management of hemorrhoidal disease.
  • To provide clear recommendations for clinical evaluation and treatment options.

Main Methods:

  • A Delphi consensus process was employed to review literature and draft statements.
  • Statements were reconciled to achieve agreement, and evidence grades were determined.
  • Guidelines are based on literature published up to June 2020.

Main Results:

  • Symptomatic hemorrhoid treatment should be individualized.
  • Low-grade hemorrhoids benefit from conservative treatment (fiber, venotropics) or instrumental options like infrared coagulation or rubber band ligation.
  • Surgery, particularly conventional hemorrhoidectomy, is recommended for refractory or non-reducible prolapsing hemorrhoids.

Conclusions:

  • New guidelines offer recommendations for clinical evaluation of hemorrhoidal disorders.
  • Guidelines cover conservative, instrumental, and surgical management strategies for hemorrhoidal disease.
Abstract

Keywords:
bleedingexternal hemorrhoidshemorrhoidal diseaseinternal hemorrhoidsprolapsethrombosis

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