Classification and guidelines of hemorrhoidal disease: Present and future

Rubbini, Michele; Ascanelli, Simona

doi:10.4240/wjgs.v11.i3.117

Cited by 51 publications

(52 citation statements)

References 23 publications

(23 reference statements)

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“…In our study, these patients were not included so as to have a study population closer to that encountered in daily practice, thereby reducing the tertiary symptoms, anal Tone, External pile) [9,10] or the Single Pile Classification score [11]. Other authors proposed composite scores that are most often unvalidated and not consensual [12], taking into account several components of hemorrhoidal disease. This is the case for the Symptom Score [13], the classification of hemorrhoids as proposed by Lunniss [14], the Symptom Questionnaire by Thaha [15], the Hemorrhoidal Severity Score (HSS) [16], the Symptom Questionnaire by Giordano et al [17], and the Sodergren Hemorrhoid Symptom Severity Score [18] which moreover does not take into account hemorrhoidal bleeding.…”

Section: Discussionmentioning

confidence: 99%

Proposal for a New Score: Hemorrhoidal Bleeding Score

Fathallah

Beaussier

Châtellier³

et al. 2021

Ann Coloproctol

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We conducted a prospective study to evaluate a new hemorrhoidal bleeding score (HBS). Methods: All consecutive patients who had consulted between May 1, 2016, and June 30, 2017 for bleeding hemorrhoidal disease were prospectively assessed at a proctological department. The study was conducted in two stages. A first stage assessed the validity of the score on a prospective patient cohort. A second stage assessed the interobserver reproducibility of the score on another prospective cohort. Results: One hundred consecutive patients were studied (57 men, mean age 49.70 years). A positive association between HBS and surgery indication was found (p<0.001). A cutoff value of the score of 5 ( 5 vs. > 5) separated patients from surgical to medical-instrumental treatment with a sensitivity and specificity of 75.00% and 81.25% respectively. In the multivariate analysis, only HBS was significantly associated with the operative decision (OR: 12.22). Prolapse was no longer significantly associated with the surgical indication. After a mean follow-up after treatment of 7 months, HBS improved statistically significantly (p<0.0001). For the reproducibility of the score, an additional 30 consecutive patients (13 men, mean age 53.14 years) were enrolled with an excellent agreement between two proctologists (kappa= 0.983). Conclusion: HBS is sensitive, specific and reproducible. It can assess the severity of hemorrhoidal bleeding. It can discriminate between the most severe surgery-indicated patients, and does so in a more efficient way than the Goligher's prolapse score. It also allows to quantify the extent of change in hemorrhoidal bleeding after treatment.

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Section: Discussionmentioning

confidence: 99%

Proposal for a New Score: Hemorrhoidal Bleeding Score

Fathallah

Beaussier

Châtellier³

et al. 2021

Ann Coloproctol

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“…Hemorrhoids are not, essentially, varicose veins, but vascular cushions composed of veins, sinusoids, arterioles, smooth muscle fibers, and connective tissue that are located in the anal canal [3,4]. In normal circumstances, hemorrhoids are normal vascular plexuses, detected in all genders and ages, including newborns.…”

Section: Introductionmentioning

confidence: 99%

“…In normal circumstances, hemorrhoids are normal vascular plexuses, detected in all genders and ages, including newborns. Anatomically, the hemorrhoids can be divided as external hemorrhoids (below the dentate line) and internal hemorrhoids (above the dentate line) [3]. The term HD is used when there are complications or related symptoms [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Although all of these symptoms can be related to HD in general, the current (and most used) classification only evaluates the internal hemorrhoids, considering only the existence and extent of prolapse during the evaluation, and it does not take into account external hemorrhoidal thrombosis. Published in 1980, Goligher classification grades the internal hemorrhoids from I to IV [3,6]. In the first degree, the hemorrhoid plexuses are insinuated through the anal canal during evacuation but do not exteriorize.…”

Section: Introductionmentioning

confidence: 99%

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A New Classification for Hemorrhoidal Disease: The Creation of the “BPRST” Staging and Its Application in Clinical Practice

et al. 2020

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Purpose: Present an updated classification for symptomatic hemorrhoids, which not only guides the treatment of internal hemorrhoids but also the treatment of external components. In addition, this new classification includes new treatment alternatives created over the last few years.Methods: Throughout the past 7 years, the authors developed a method to classify patients with symptomatic hemorrhoids. This study, besides presenting this classification proposal, also retrospectively analyzed 149 consecutive patients treated between March 2011 and November 2013 and aimed to evaluate the association between the management adopted with Goligher classification and our proposed BPRST classification.Results: Both classifications had a statistically significant association with the adopted management strategies. However, the BPRST classification tended to have fewer management discrepancies when each stage of disease was individually analyzed.Conclusion: Although there is much disagreement about how the classification of hemorrhoidal disease should be updated, it is accepted that some kind of revision is needed. The BPRST method showed a strong association with the management that should be adopted for each stage of the disease. Further studies are needed for its validation, but the current results are encouraging.

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“…Symptoms that may be experienced include pain and bleeding in bowel movements. Pain usually increases when the sufferers are in sitting position because the swollen veins are depressed when the patient sits, especially when sitting without a hard cushion 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Underwear innovation for hemorrhoids patient

Setiyaningsih

Utami²,

Nugroho³

et al. 2020

medisians

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Background: Symptoms experienced hemorrhoid sufferers are feeling pain in the anus, especially in sitting position. It is necessary to innovate special underwear which can reduce pressure on the anus and the pain experienced by the patientObjective: the study aimed to create and analyze special underwear for hemorrhoid sufferers which increased comfort and reduce the intensity of pain.Methods: This research imitated Research and Development (R&D. It consisted of 3 stages; stage I (literature study), stage II (product development) and stage III (product experiment).Result: The literature study in stage I obtained materials used to create special underwear for hemorrhoid sufferers by Cotton Combed 30s of 100% premium cotton and foam as a cushion. In the second phase of the research, designs and shapes were obtained. The results of product experiment in the third phase of the study discovered that respondents felt more comfortable by the special underwear than ordinary underwear and it was very effective in reducing pain.Conclusion: The innovation of hemorrhoid underwear is effective to increase comfort and reduce pain intensity in hemorrhoid sufferers.

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Classification and guidelines of hemorrhoidal disease: Present and future

Cited by 51 publications

References 23 publications

Proposal for a New Score: Hemorrhoidal Bleeding Score

Proposal for a New Score: Hemorrhoidal Bleeding Score

A New Classification for Hemorrhoidal Disease: The Creation of the “BPRST” Staging and Its Application in Clinical Practice

Underwear innovation for hemorrhoids patient

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