Modern management of hemorrhoids

Area of Science:

• Gastroenterology
• Colorectal Surgery

Background:

• Hemorrhoids are a common condition requiring intervention only when symptomatic.
• Symptomatic hemorrhoids range from mild to severe, influencing treatment selection.

Purpose of the Study:

• To outline current therapeutic strategies for symptomatic hemorrhoids.
• To differentiate treatment approaches based on hemorrhoid severity and presentation.

Main Methods:

• Conservative management includes dietary modifications (fiber, fluids) and bulk-forming agents.
• Minimally invasive procedures like rubber band ligation are indicated for small to moderate hemorrhoids.
• Surgical intervention, specifically closed hemorrhoidectomy, is recommended for large or thrombosed hemorrhoids.

Main Results:

• Dietary measures effectively manage early, occasional symptoms by promoting soft stools.
• Rubber band ligation at the anorectal junction is effective for bleeding hemorrhoids with minimal prolapse.
• Closed hemorrhoidectomy offers rapid healing, minimal postoperative care, and few complications for severe hemorrhoids.

Conclusions:

• Treatment selection for hemorrhoids depends on symptom severity and prolapse.
• Dietary changes, rubber band ligation, and closed hemorrhoidectomy represent the primary evidence-based treatments.
• Alternative therapies are generally less suitable for routine use due to disadvantages.