ABSTRACT
Hemorrhoids result from disruption of the anal cushions and are a common problem, equally affecting men and women. Internal hemorrhoids occur just proximal to the dentate line and are largely painless, most commonly present with bleeding, and can be mild, with reversible prolapse, manually reducible, or unable to be reduced. Treatment options are driven by clinical symptoms and grade. Hemorrhoids are visible on physical examination, but the diagnosis is most commonly made based on clinical history. The mainstay of medical management for hemorrhoid disease remains dietary and habit modification. Increased fiber and fluid intake to improve symptoms of constipation, and limiting straining and commode time are recommended. Surgical management is the gold standard in the treatment of severe hemorrhoids, and several options including excisional hemorrhoidectomy, ligasure hemorrhoidectomy, stapled hemorrhoidopexy, and hemorrhoidal artery ligation are described. Hemorrhoids are a common problem and most effectively treated with an approach tailored to the grade and degree of symptomatology.
