Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

Abstract

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.

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

“…The study of anorectal diseases, particularly HD, has deepened over the last few years, with the establishment of new therapeutic methods [ 3 , 5 , 9 , 10 , 12 , 21 , 22 ]. Such modernization extends the possibilities of treatment, which was once limited to clinical treatment for grade I and II internal hemorrhoids and conventional surgery for grades III and IV [ 6 ].…”

“…So, in order to evaluate our method capability of predicting management, we retrospectively analyzed 149 medical records of patients that were treated in accordance with the current guidelines and classified them according to Goligher classification and our BPRST classification [3,9,10].…”

“…At admission, all patients were classified according to Goligher classification and evaluated for their main complaints and signs found on physical examination. Their treatment was guided according to current guidelines and surgeon's preference based on the best practice of hemorrhoid care [9,10].…”

Комплексна Оцінка Ефективності Ексцизійних Методів Гемороїдектомії

“…Гемороїдальна хвороба (ГХ) все ще залишається одним із найпоширеніших захворювань людини. За даними ряду авторів, захворюваність на ГХ становить 130-150 на 1000 осіб дорослого населення, а питома вага в структурі колопроктологічних захворювань коливається від 30 до 40 % [1]. Поширення цього захворювання в індустріально розвинутих країнах набуває характеру епідемії, що призводить до ураження великої кількості людей працездатного віку, тривалої тимчасової непрацездатності тощо [2].…”

Common sense of diosmin administration in combined treatment of hemorrhoids

“…Японские практические рекомендации (2017 г.) большое значение в консервативных методах лечения геморроя придают изменению ежедневного образа жизни (Everyday Lifestyle Guidance), выделены ограничение длительного сидячего положения, работы в холодных условиях, натуживания при дефекации, тщательный выбор продуктов еды и питья, умеренные физические нагрузки и снижение эмоциональных стрессов [39]. В рекомендациях выражен определенный скепсис в отношении успеха консервативного лечения выпадающего геморроя III-IV стадии.…”