Overview
Hemorrhoids are naturally occurring vascular structures
located within the submucosa of the anal canal, consisting of loose connective
tissue, smooth muscle (Treitz’s muscle), and blood vessels with numerous
arteriovenous connections accounting for the bright red color of hemorrhoidal
bleeding, as stated in the Introduction
section.
Hemorrhoids affect approximately 4.4% of the global
population, with the highest prevalence observed among individuals aged 45-65
years. A detailed discussion about the prevalence of hemorrhoids is in the Epidemiology section.
The Pathophysiology section states that hemorrhoids are associated with
conditions that increase intra-abdominal pressure, leading to impaired venous
return from the hemorrhoidal veins and a subsequent pathologic enlargement of
the vascular cushions that results in symptomatic hemorrhoids. The
development process of hemorrhoids is discussed in this section.
The Risk Factors section lists conditions that increase the
likelihood of developing hemorrhoids.
The differences between external and internal hemorrhoids are
explained in the Classification section.
Hemorrhoids_Disease SummaryHistory and Physical Examination
The Clinical Presentation section describes the clinical features commonly
seen in patients with hemorrhoids.
The History
section contains important information that should be gathered during the
evaluation of patients with hemorrhoids.
The Physical Examination section outlines the appropriate evaluation
of patients with hemorrhoids and explains the use of anoscopy.
The Screening section lists the grading of internal
hemorrhoids.
Diagnosis
Discussion in visualization procedures that will aid in the
diagnosis of hemorrhoids is in the Imaging section.
Other anorectal conditions that should be considered when
evaluating symptoms suggestive of hemorrhoids are listed in the Differential Diagnosis section.
Management
Clinical decisions regarding treatment options in patients
with hemorrhoids are explained in the Evaluation
section.
General therapy principles of ablative office procedures and
surgical hemorrhoidectomy in the management of hemorrhoids are in the Principles of Therapy section.
The Pharmacological
Therapy section discusses in
detail available pharmacologic preparations for the relief of hemorrhoidal
symptoms such as analgesics, topical corticosteroids, herbal medicines and
other agents.
The Nonpharmacological
section includes things to educate the patient about the management of hemorrhoids
and the importance of dietary modifications and other supportive measures. Different
options for ablative office procedures are also discussed in this section.
Options for surgical therapy such as open, closed and
stapled hemorrhoidectomy are discussed in the Surgery section.