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[Hemorrhoids. Review]

R Vanheuverzwyn1, J F Colin, T Van Wymersch

  • 1Service de Gastro-Entérologie, Cliniques Universitaires Saint Luc. Bruxelles.

Acta Gastro-Enterologica Belgica
|September 1, 1995
PubMed
Summary
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Haemorrhoidal disease, linked to internal haemorrhoidal plexus issues, requires precise definition for accurate incidence and treatment. Dietary changes help mild cases, rubber band ligation moderate ones, and surgery advanced prolapsing haemorrhoids.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Context:

  • Haemorrhoidal disease definition and classification are crucial for epidemiological studies and therapeutic decision-making.
  • Current understanding of the aetiopathogenesis of haemorrhoidal disease points towards degeneration of the internal haemorrhoidal plexus fibromuscular structure.
  • Accurate definition of haemorrhoidal disease is essential for estimating incidence and guiding therapeutic choices.

Purpose:

  • To clarify the definition of haemorrhoidal disease, emphasizing its specific association with abnormalities of the internal haemorrhoidal plexus.
  • To review the current understanding of haemorrhoidal disease classification, aetiopathogenesis, and treatment modalities.
  • To provide a framework for consistent diagnosis and management of haemorrhoidal disease.

Summary:

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  • Haemorrhoidal disease should be specifically defined as symptoms arising from abnormalities of the internal haemorrhoidal plexus.
  • While classification systems exist, their application to individual cases remains challenging.
  • The aetiopathogenesis is thought to involve progressive degeneration of the internal haemorrhoidal plexus, leading to prolapse.
  • Conservative management (dietary advice) is effective for many patients.
  • Rubber band ligation is a key treatment for moderate prolapsing haemorrhoids.
  • Surgical haemorrhoidectomy is the preferred option for advanced cases.

    • Impact:

    • Standardized definition and classification of haemorrhoidal disease will improve research accuracy and clinical practice.
    • Clearer understanding of aetiopathogenesis may lead to novel therapeutic strategies.
    • Optimized treatment selection based on disease severity can improve patient outcomes and reduce healthcare costs.