Hemorrhoid Management

Hemorrhoidal disease is one of the most common ailments in the United States, affecting about 4% of the population with a healthcare burden of over $700 million. Though a part of normal human anatomy, the term “hemorrhoid” is often used ubiquitously to describe the pathologic form of hemorrhoids and sometimes other unrelated anorectal pathology. Pathologic symptoms from hemorrhoids can be more specifically produced by internal and/or external hemorrhoid components. Symptoms can include bleeding, thrombosis, perianal irritation/itching, and swelling from engorgement. There are multiple therapeutic options to address hemorrhoidal disease including fiber supplementation, rubber band ligation, excisional hemorrhoidectomy, stapled hemorrhoidpexy, transanal hemorrhoidal dearterialization, and sclerotherapy. Each therapy has its indications, risks, and benefits and the treatment approach often comes down to the severity of hemorrhoid disease, the constellation of symptoms, and patient preferences.