Management options for symptomatic hemorrhoids

Abstract

Hemorrhoids remain one of the most common colorectal complaints. They are defined as a pathologic engorgement of the submucosal vascular plexus. Although they are often asymptomatic, hemorrhoids may cause bleeding, prolapse and, less commonly, pain. This review gives an update on various treatment options for symptomatic hemorrhoids, which include conservative treatments, office interventions, and surgical procedures, depending on the individual constellation of symptoms. Objective findings and expectations are also addressed. Recent advances (eg, stapled hemorrhoidectomy and use of alternate energy sources) are emphasized, and treatment under special circumstances (HIV, pregnancy, inflammatory bowel disease, and liver disease) is outlined.

Stapled haemorrhoidectomy (haemorrhoidopexy) for the treatment of haemorrhoids: a systematic review and economic evaluation

“…15 If haemorrhoids develop during pregnancy, it tends to be in the third trimester. 17 Management should be as conservative as possible to avoid risks to the foetus, 17 with surgery only undertaken for intractable disease, and delayed until the foetus is viable. 4 Performing the procedure under local anaesthetic is considered to be the safest option.…”

“…6 Assessment of these interventions is beyond the scope of this review; further information can be found elsewhere. 4,14,17,20,23 …”

Cryosurgery and ligation (Cryo-plication) of symptomatic hemorrhoids — “an ideal procedure”. Initial experience and review of literature

“…Although this study is a very small sized observational. Post-operative pain after open technique is very distressing in most of the patients up to 2 weeks or more [4,5]. Anal stenosis is seen due to loss of mucosal lining and scarring in 2.9-5.0% cases after open hemorrhoidectomy [6].…”

A review of the archaeological analogue approaches to predict the long-term corrosion behaviour of carbon steel overpack and reinforced concrete structures in the French disposal systems

“…So, as well as for the carbon, for the same sample it is possible in a given environment, to study the potential effect of the presence of slag inclusions incorporated into the metallic matrix on the local mechanisms of corrosion. Furthermore, some minor elements as phosphorus [34] can be present in the metallic substrate of ancient iron based artefacts. This element is avoided in contemporary metal industry and it must be verified that it is not present in objects considered as analogues.…”