Treatment of uncomplicated hemorrhoids

Topical treatment of hemorrhoids dates back to 1700bc and the first surgical treatment was described in 460BC¹ in the Hippocratic Treatises. The principles of treatment of hemorrhoids have changed little over the centuries, even if the techniques have evolved. John Morgan first used sclerotherapy in 1869 in Dublin to obliterate hemorrhoids by using iron persulfate.² Although ligation of the hemorrhoidal mass has been the basis of many treatments over the centuries, band ligation was first described by Blaisdell in 1954;³ the technique was later modified by Barron in 1963.⁴ Neiger described the use of infrared coagulation to treat hemorrhoids in 1979.⁵ Newer coagulative techniques continue to evolve. A more recent technique, Doppler-guided transanal hemorrhoidal dearterialization (HAL) may bridge the gap between non-surgical techniques and excisional hemorrhoidectomy (open, closed, or stapled). HAL was first described by the Japanese surgeon, Kazumasa Morinaga in 1995.⁶