The pathogenesis of
hemorrhoids is a weakening of the anal cushion and
spasm of the internal sphincter. Bowel habits and lifestyles can be risk factors for
hemorrhoids. The prevalence of
hemorrhoids can encompass 4 to 55% of the population. Symptoms include
bleeding,
pain, prolapsing, swelling,
itching, and mucus soiling. The diagnosis of
hemorrhoids requires taking a thorough history and conducting an anorectal examination. Goligher's classification, which indicates the degree of prolapsing with internal
hemorrhoids, is useful for choosing treatment.
Drug therapy for
hemorrhoids is typically utilized for
bleeding,
pain, and swelling.
Ligation and excision (LE) is considered for Grade III and IV internal and external
hemorrhoids. Rubber band
ligation is used to treat up to Grade III internal
hemorrhoids.
Phenol almond oil is effective for internal
hemorrhoids up to Grade III, while
aluminum potassium sulfate and
tannic acid have shown efficacy in treating prolapsing in internal
hemorrhoids at Grades II, III, and IV. Procedure for
prolapse and
hemorrhoids (PPH) is surgically effective for Grade III internal
hemorrhoids; however, the long-term prognosis is not favorable, with high recurrence rates. Separating
ligation is effective surgical treatment for internal/external
hemorrhoids Grade III and Grade IV. The basic approach to thrombosed external
hemorrhoids and incarcerated
hemorrhoids is
conservative treatment; however, in some acute or severe cases, surgical resection is considered. Comparing the different instruments used for
hemorrhoid surgery, all reduce operating time, blood loss,
post-operative pain, and length of time until the return to normal activity. They do, of course, increase the cost of the procedure.