Hemorrhoids: a plea for nonsurgical treatment

Area of Science:

• Gastroenterology
• Colorectal Surgery

Background:

• Hemorrhoids are a common condition with various treatment options.
• While conservative therapies are often effective, many patients require active interventions.
• The optimal surgical or minimally invasive approach for hemorrhoids remains unclear.

Purpose of the Study:

• To review the available literature on comparative controlled trials of different hemorrhoid treatment methods.
• To compare the efficacy of various active treatments for hemorrhoids.

Main Methods:

• Systematic review of scanty literature on comparative controlled trials.
• Analysis of studies comparing surgical hemorrhoidectomy with other methods like injection therapy, elastic band ligation, cryosurgery, anal dilatation, and lateral subcutaneous sphincterotomy.

Main Results:

• Formal hemorrhoidectomy appears to be rarely necessary.
• Elastic band ligation and anal dilatation demonstrate results that compare very favorably with traditional surgery.
• These minimally invasive techniques are effective for patients unresponsive to conservative therapy.

Conclusions:

• Elastic band ligation and anal dilatation are highly effective treatment options for hemorrhoids.
• These methods should be strongly considered for patients who do not respond to conservative management.
• Minimally invasive treatments offer a favorable alternative to formal hemorrhoidectomy.