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Home > Archives > Volume 20, No 11 (2022) > Article

DOI: 10.14704/nq.2022.20.11.NQ66095

Update Review of Evaluation and Management of Hemorrhoids

EslamFayzTolba Nada, Hany Mohamed, Hatem Mohammad Abdelmoneim, Elsayed I.Elhendawey


Background:Hemorrhoid disease is not a recent development. Hemorrhoids are edematous masses of pale connective tissue surrounded by mucosa that ranges in color from gray to tan.Typical excised hemorrhoidal tissue measures a few centimeters in aggregate.Themostfrequent signsarebleeding,analswelling, prolapse, discomfort, pain, discharge,hygiene problems, and pruritus.Hemorrhoids are classified according to how close they are to the dentate line. These can be classified as internal, external, or mixed.Topical treatment of hemorrhoids was mentioned in Egyptian writings from 1700 BC, and the first report of a surgical treatment (a hemorrhoidopexy of sorts) was included in the Hippocratic Treatises of 460 BC.The anoscope is an excellent instrument with which to examine the introitus and distal rectum. The exam can be quickly performed at the bedside, without sedation or prep, using very inexpensive, disposable, self-lighted instruments. All too often the flexible endoscope is utilized to evaluate the anorectum, but unfortunately, these techniques are less accurate than simple anoscopy. When the patient’s intermittent problem recurs, the production of an image can facilitate the diagnosis, particularly of early rectal prolapse, which may not be not severe enough to show itself on physical examination. Several techniques attempts to correct the hemorrhoidal cushion prolapse by causing a re-fixation of the tissue to the underlying structures, as well as to decrease vascularity and to reduce some of the redundant tissue, and each technique has its strengths and weaknesses. Therefore, the aim of the present study was toreview and summarize the proper evaluation and management of hemorrhoid diseases.


Hemorrhoids;Diagnosis;Surgical Intervention

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