[Hemorrhoidal disease]

Prevalence of hemorrhoidal diseases in proctologic practice has decreased over the past years. Inflammatory and functional diseases predominant as a consequence of improved differential diagnosis and diagnostic management. In less than 20% of patients of a specialized practice stage-adapted therapy is indicated. Favorable long term results, however, are barely obtainable without elimination of pathogenic factors. If inflammatory and/or functional disorders of the anal region are not eliminated relapses are preprogrammed.