Outpatient management of hemorrhoids

• Published in: Seminars in colon and rectal surgery Vol. 24; no. 2; pp. 76 - 80
• Main Authors: Moss, Angela K., MD, Bordeianou, Liliana, MD, MPH
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.06.2013
• Subjects: Gastroenterology and Hepatology; Surgery
• ISSN: 1043-1489; 1558-4585
• DOI: 10.1053/j.scrs.2013.02.004

Abstract Hemorrhoids are a common anorectal condition characterized by bleeding, thrombosis, and prolapse. Initial treatment is usually focused on nonoperative interventions. Behavior modifications including sitz baths, regular exercise, consuming a low-fat diet, avoidance of excessive time on the toilet, and minimizing constipating medications may provide symptomatic relief. Oral fiber supplementation is safe and highly effective. A variety of nonsurgical ablative treatments exist, including rubber band ligation, injection sclerotherapy, and infrared photocoagulation; each of which offers unique advantages. Patients presenting with thrombosed external hemorrhoids and 48–72 h of symptoms usually benefit from excision of the hemorrhoid. More invasive options aimed at ablation of hemorrhoids are reserved for patients with persistent symptoms or higher grade hemorrhoids.