Diagnosis and Management of Internal Hemorrhoids: A Brief Review
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Hemorrhoidal disease is a pathological condition due to the abnormal engorgement of the arteriovenous plexus beneath the anal mucosa. Anatomically, it can be located under the skin on the outer part of the dentate line, known as external hemorrhoid; or inside the anus on the proximal part of the dentate line, called internal hemorrhoid. Internal hemorrhoid may further develop from a painless anal mass into protruded and painful mass throughout the anal canal, often accompanied by inflammation and more severe symptoms. Various management strategies need to be considered carefully to ensure the success of therapy and improve the quality of life of patients with internal hemorrhoids. Conservative management is the initial stage that can be performed, including the provision of high-fiber nutrition, education related to bathroom habits, and the use of flavonoid regimens. Surgical therapy can be divided into outpatient intervention and conventional surgeries. This review will encompass the comprehensive diagnostic approach and management of internal hemorrhoids to help clinicians understand the appropriate management and provide better clinical benefits for the patients.
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References
-
R. F. Fontem, D. Eyvazzadeh (August 2020). Internal hemorrhoid. Treasure Island (FL): StatPearls Publishing [Online]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537182/.
Google Scholar
1
-
R. C. G. Russel, N. S. Williams, C. J. K. Bulstrode, Ed., Bailey & Love’s Short Practice of Surgery, 23rd ed. London, U.K.: Oxford Press, 2003, pp. 1128.
Google Scholar
2
-
A. G. Acheson, J. H. Scholefield, “Management of haemorrhoids,” BMJ, vol. 336, no. 7640, pp. 380-383, Feb. 2008.
Google Scholar
3
-
E. B. Sneider, J. A. Maykel, “Diagnosis and management of symptomatic hemorrhoids,” Surg. Clin. North. Am., vol. 90, no. 1, pp. 17-32, Feb 2010.
Google Scholar
4
-
S. R. Brown, “Haemorrhoids: an update on management,” Ther. Adv. Chronic Dis., vol. 8, no. 10, pp. 141-147, Oct 2017.
Google Scholar
5
-
N. Margetis, “Pathophysiology of internal hemorrhoids,” Ann. Gastroenterol., vol. 32, no. 3, pp. 264-272, May 2019.
Google Scholar
6
-
J. Fleshman, R. Madoff, “Hemorrhoids,” in Current Surgical Therapy, 8th ed., J. Cameron. Philadelphia: Elsevier, 2004, pp. 245-252.
Google Scholar
7
-
F. Aigner, H. Gruber, F. Conrad, et al., “Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease,” Int. J. Colorectal. Dis., vol. 24, no. 1, pp. 105-113, Jan 2009.
Google Scholar
8
-
Harvard Women’s Health Watch (August 2020). Hemorrhoids and what to do about them. Harvard Health Publishing [Online]. Available from: https://www.health.harvard.edu/diseases-and-conditions/ hemorrhoids_ and_what_to_do_about_them.
Google Scholar
9
-
V. M. Stolfi, P. Sileri, C. Micossi, et al., “Treatment of hemorrhoids in day surgery: stapled hemorrhoidopexy vs Milligan-Morgan hemorrhoidectomy,” J. Gastrointest. Surg., vol. 12, no. 5, pp. 795-801, May 2008.
Google Scholar
10
-
P. Cataldo, C. N. Ellis, S. Gregorcyk, et al., Standards Prac¬tice Task Force, The American Society of Colon and Rectal Surgeons, USA, “Practice parameters for the man¬agement of hemorrhoids (revised),” Dis. Colon Rectum., vol. 48, no. 2, pp. 189-194, Feb 2005.
Google Scholar
11
-
L. Abramowitz, G. H. Weyandt, B. Havlickova, et al., “The diagnosis and management of haemorrhoidal disease from a global perspective,” Aliment. Pharmacol. Ther. vol. 31, no. 1, pp. 1-58, May 2010.
Google Scholar
12
-
M. L. Welton, G. J. Chang, A. A. Shelton, “Hemorrhoids,” in Current Surgical Diagnosis and Treatment, 12th ed., G. M. Doherty, Ed. New York: Lange, 2006, pp. 738-764.
Google Scholar
13
-
J. Cintron, H. Abcarian, “Benign anorectal: hemorrhoids,” in The ASCRS Textbook of Colon and Rectal Surgery, B. G. Wolff, J. W. Fleshman, D. E. Beck, et al., Ed., New York: Springer-Verlag, Inc, 2007, pp. 156-177.
Google Scholar
14
-
D. Yeo, K. Y. Tan, “Hemorrhoidectomy—making sense of the surgical options,” World J. Gastroenterol., vol. 20, no. 45, pp. 16976-16983, 2014.
Google Scholar
15
-
T. Mott, K. Latimer, C. Edwards C, “Hemorrhoids: diagnosis and treatment options,” AAFP, vol. 97, no. 3, pp. 172-179, 2018.
Google Scholar
16
-
D. E. Beck, P. L. Roberts, J. L. Rombeau, et al., The ASCRS Manual of Colon and Rectal Surgery, New York, NY: Springer, 2009, pp. 225-257.
Google Scholar
17
-
D. E. Rivadeneira, S. R. Steele, C. Ternent, et al., “Practice parameters for the management of hemorrhoids (revised 2010),” Dis. Colon Rectum, vol. 54, no. 9, pp. 1059-1064, 2011.
Google Scholar
18
-
P. Godeberge, P. Sheikh, V. Lohsiriwat, et al., “Micronized purified flavonoid fraction in the treatment of hemorrhoidal disease,” J. Comp. Eff. Res., vol. 10, no. 10, pp. 801-813, 2021.
Google Scholar
19
-
V. S. Iyer, I. Shrier, P. H. Gordon, “Long-term outcome of rubber band ligation for symptomatic primary and recurrent internal hemorrhoids,” Dis. Colon Rectum, vol. 47, no. 8, pp. 1364-1370, 2004.
Google Scholar
20
-
Adapted from J. Cintron, H. Abcarian, “Benign anorectal: hemorrhoids,” in The ASCRS Textbook of Colon and Rectal Surgery, B. G. Wolff, J. W. Fleshman, D. E. Beck, et al., Ed., New York: Springer-Verlag, Inc, 2007, pp. 156-177.
Google Scholar
21
-
R. J. Longman, W. H. Thomson, “A prospective study of outcome from rubber band ligation of piles,” Colorectal Dis., vol. 8, pp. 145-148, 2006.
Google Scholar
22
-
A. Izadpanah, S. Hosseini, M. Mahjoob, “Comparison of electrotherapy, rubber band ligation and hemorrhoidectomy in the treatment of hemorrhoids: a clinical and manometric study,” Middle East J. Dig. Dis., vol. 2, pp. 9-13, 2010.
Google Scholar
23
-
American Gastroenterological Association, “American gastroenterological association technical review on diagnosis and treatment of hemorrhoids,” Gastroenterology, vol. 126, pp. 1463-1473, 2004.
Google Scholar
24
-
R. Shekhar, V. K. Gupta, “Efficacy of foam sclerotherapy in treatment of grade I and grade II bleeding hemorrhoids at Nalanda Medical College and hospital, Patna,” Int. Surg. J., vol. 7, no. 9, pp. 2925-2928, 2020.
Google Scholar
25
-
T. Yano T, Yano K, “Comparison of injection sclerotherapy between 5% phenol in almond oil and aluminum potassium sulfate and tannic acid for grade 3 hemorrhoids,” Ann. Coloproctol., vol. 31, pp. 103-105, 2015.
Google Scholar
26
-
K. H. Moser, C. Mosch, M. Walgenbach, et al., “Efficacy and safety of sclerotherapy with polidocanol foam in comparison with fluid sclerosant in the treatment of first-grade haemorrhoidal disease: a randomised, controlled, single-blind, multicentre trial,” Int. J. Colorectal Dis., vol. 28, pp. 1439-1447, 2013.
Google Scholar
27
-
O. Kaidar-Person, B. Person, S. D. Wexner, “Hemorrhoidal disease: A comprehensive review,” J. Am. Coll. Surg., vol. 204, pp. 102-117, 2007.
Google Scholar
28
-
M. P. Ricci, D. Matos, S. S. Saad, “Rubber band ligation and infrared photocoagulation for the outpatient treatment of hemorrhoidal disease,” Acta Cir. Bras., vol. 23, pp. 102-106, 2008.
Google Scholar
29
-
C. F. Marques, S. C. Nahas, C. S. R. Nahas, et al., “Early results of the treatment of internal hemorrhoid disease by infrared coagulation and elastic banding: a prospective randomized cross-over trial,” Tech. Coloproctol., vol. 10, pp. 312-317, 2006.
Google Scholar
30
-
B. R. Kann, C. B. Whitlow, “Hemorrhoids: diagnosis and management,” Tech. Gastrointest. Endosc., vol. 6, no. 1, pp. 6-11, 2004.
Google Scholar
31
-
V. Lohsiriwat, D. Lohsiriwat, “Ambulatory anorectal surgery under perianal anesthetics infiltration: analysis of 222 cases,” J. Med. Assoc. Thai, vol. 90, pp. 278-281, 2007.
Google Scholar
32
-
E. K. Tan, J. Cornish, A. W. Darzi, et al., “Meta-analysis of short-term outcomes of randomized controlled trials of LigaSure vs conventional hemorrhoidectomy,” Arch. Surg., vol. 142, pp. 1209-1218, 2007.
Google Scholar
33
-
J. Rakinic, “Benign anorectal surgery: management,” Adv. Surg., vol. 52, pp. 179-204, 2018.
Google Scholar
34
-
J. F. Gravié, P. A. Lehur, N. Huten, et al., “Stapled hemorrhoidopexy versus Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up,” Ann. Surg., vol. 242, pp. 29-35, 2005.
Google Scholar
35
-
P. Giordano, G. Gravante, R. Sorge, et al., “Long term outcomes of stapled hemorrhoidopexy vs conventional hemorrhoidectomy,” Arch. Surg., vol. 144, no. 3, pp. 266-272, 2009.
Google Scholar
36
-
N. Malyadri, V. J. Allu, “A prospective comparative study of stapler hemorrhoidectomy vs open hemorrhoidectomy (Milligan Morgan) in its outcome and postoperative complications,” J. Surg. Res., vol. 4, no. 1, pp. 4-13, 2021.
Google Scholar
37
-
P. O. Nyström, N. Qvist, D. Raahave, et al.; Stapled or Open Pile Procedure (STOPP) trial study group, “Randomized clinical trial of symptom control after stapled anopexy or diathermy excision for haemorrhoid prolapse,” Br. J. Surg. vol. 97, pp. 167-176, 2010.
Google Scholar
38
-
C. Ratto, L. Donisi, A. Parello, et al., “Evaluation of transanal hemorrhoidal dearterialization as a minimally invasive therapeutic approach to hemorrhoids,” Dis. Colon Rectum. vol. 53, no. 5, pp. 803-811, 2010.
Google Scholar
39
-
C. G. Karadeniz, O. Irkorucu, B. H. Ucan, et al., “Fournier’s gangrene after open hemorrhoidectomy without a predisposing factor: report of a case and review of the literature,” Case Rep. Gastroenterol., vol. 3, no. 2, pp. 147-155, 2009.
Google Scholar
40
-
S. P. Brodovskyi, A. G. Iftodiy, I. M. Kozlovska, “Оptimization of surgical treatment of hemorrhoidal disease stages III-IV,” Klin. Khir. vol. 2017, no. 2, pp. 10-12, 2017.
Google Scholar
41
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