The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids

Davis, Bradley R.; Lee-Kong, Steven A.; Migaly, John; Feingold, Daniel L.; Steele, Scott R.

doi:10.1097/dcr.0000000000001030

Cited by 259 publications

(286 citation statements)

References 56 publications

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“…Nonsurgical approaches are preferred for lower grade hemorrhoids because of the physiologic importance of the hemorrhoid cushions and potential self‐limiting nature of many hemorrhoid symptoms . When conservative therapy fails, clinical practice guidelines recommend office‐based procedures such as banding, sclerotherapy, and infrared coagulation for Grade I to III hemorrhoids .…”

Section: Discussionmentioning

confidence: 99%

“…Nonsurgical approaches are preferred for lower grade hemorrhoids because of the physiologic importance of the hemorrhoid cushions and potential self-limiting nature of many hemorrhoid symptoms. 12,17,20,21 When conservative therapy fails, clinical practice guidelines recommend office-based procedures such as banding, sclerotherapy, and infrared coagulation for Grade I to III hemorrhoids. 20,22 Surgical options such as hemorrhoidectomy, stapled hemorrhoidopexy, or hemorrhoidal artery ligation may be the initial step in patients with Grade III or IV hemorrhoids or in those who are refractory to or cannot tolerate office procedures.…”

Section: Discussionmentioning

confidence: 99%

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Hemorrhoidal disease and chronic venous insufficiency: Concomitance or coincidence; results of the CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research)

Godeberge¹,

Sheikh

Загрядский³

et al. 2019

J of Gastro and Hepatol

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Background and Aim The CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research) was conducted to provide data on patients presenting with hemorrhoidal disease (HD) in clinical practice and to explore the frequency with which it coexists with chronic venous disease (CVD) and shared risk factors. Methods This international, noninterventional study enrolled adult patients attending a consultation for hemorrhoidal complaints. The questionnaire completed by physicians established the subjects' demographic and lifestyle characteristics and collected information on HD grade and symptoms and signs of CVD. Results A total of 5617 patients were analyzed. Symptoms commonly reported were bleeding (71.8%), pain (67.4%), swelling (55.0%), itching (44.1%), and prolapse (36.2%). Multivariate analysis revealed the variables with the strongest association with HD severity were older age, higher CVD CEAP (Clinical manifestations, Etiologic factors, Anatomic distribution of disease, and underlying Pathophysiology) class, constipation, and male gender (all P < 0.0001). Elevated BMI was a risk factor for HD recurrence. Among women, number of births had a significant association with both HD grade and recurrence. The presence of CVD, reported in approximately half the patients (51.2%), was strongly associated with advanced grade of HD (P < 0.0001). Treatments most commonly prescribed were venoactive drugs (94.3%), dietary fiber (71.4%), topical treatment (70.3%), analgesics (26.3%), and surgery (23.5%). Conclusions CHORUS provides a snap shot of current profiles, risk factors, and treatments of patients with HD across the globe. The coexistence of HD and CVD in more than half the study population highlights the importance of examining for CVD among patients with a hemorrhoid diagnosis, particularly when shared risk factors are present.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hemorrhoidal disease and chronic venous insufficiency: Concomitance or coincidence; results of the CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research)

Godeberge¹,

Sheikh

Загрядский³

et al. 2019

J of Gastro and Hepatol

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show abstract

“…Depending on its severity, HD can be effectively treated with medical and office‐based procedures such as rubber‐band ligation or sclerotherapy or various surgical approaches . Sclerotherapy has been described for treating Grade I–III HD . The injection of a sclerosing agent such as polidocanol provokes an inflammatory reaction with subsequent necrosis, fibrosis and fixation of the haemorrhoidal tissue.…”

mentioning

confidence: 99%

The use of sclerotherapy with polidocanol foam in the treatment of second‐degree haemorrhoidal disease – a video vignette

et al. 2018

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“…Depending on its severity, HD can be effectively treated with medical and office-based procedures such as rubber-band ligation or sclerotherapy [1] or various surgical approaches [2]. Sclerotherapy has been described for treating Grade I-III HD [3]. The injection of a sclerosing agent such as polidocanol provokes an inflammatory reaction with subsequent necrosis, fibrosis and fixation of the haemorrhoidal tissue.…”

Section: Supporting Informationmentioning

confidence: 99%

First aid toolkit for anal fistulas, a detailed treatise for trainees – a video vignette (ESCP Trainee Video)

Zimmerman

2018

Colorectal Disease

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The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids

Cited by 259 publications

References 56 publications

Hemorrhoidal disease and chronic venous insufficiency: Concomitance or coincidence; results of the CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research)

Hemorrhoidal disease and chronic venous insufficiency: Concomitance or coincidence; results of the CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research)

The use of sclerotherapy with polidocanol foam in the treatment of second‐degree haemorrhoidal disease – a video vignette

First aid toolkit for anal fistulas, a detailed treatise for trainees – a video vignette (ESCP Trainee Video)

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