Diagnosis and Management of Internal Hemorrhoids: A Brief Review

##plugins.themes.bootstrap3.article.main##

  •   Stephen William Soeseno

  •   P. Agus Eka Wahyudi

  •   Febyan Febyan

Abstract

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.


Keywords: Hemorrhoids, anorectal, anal bleeding, surgical management

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/.

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.

A. G. Acheson, J. H. Scholefield, “Management of haemorrhoids,” BMJ, vol. 336, no. 7640, pp. 380-383, Feb. 2008.

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.

S. R. Brown, “Haemorrhoids: an update on management,” Ther. Adv. Chronic Dis., vol. 8, no. 10, pp. 141-147, Oct 2017.

N. Margetis, “Pathophysiology of internal hemorrhoids,” Ann. Gastroenterol., vol. 32, no. 3, pp. 264-272, May 2019.

J. Fleshman, R. Madoff, “Hemorrhoids,” in Current Surgical Therapy, 8th ed., J. Cameron. Philadelphia: Elsevier, 2004, pp. 245-252.

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.

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.

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.

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.

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.

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.

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.

D. Yeo, K. Y. Tan, “Hemorrhoidectomy—making sense of the surgical options,” World J. Gastroenterol., vol. 20, no. 45, pp. 16976-16983, 2014.

T. Mott, K. Latimer, C. Edwards C, “Hemorrhoids: diagnosis and treatment options,” AAFP, vol. 97, no. 3, pp. 172-179, 2018.

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.

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.

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.

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.

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.

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.

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.

American Gastroenterological Association, “American gastroenterological association technical review on diagnosis and treatment of hemorrhoids,” Gastroenterology, vol. 126, pp. 1463-1473, 2004.

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.

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.

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.

O. Kaidar-Person, B. Person, S. D. Wexner, “Hemorrhoidal disease: A comprehensive review,” J. Am. Coll. Surg., vol. 204, pp. 102-117, 2007.

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.

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.

B. R. Kann, C. B. Whitlow, “Hemorrhoids: diagnosis and management,” Tech. Gastrointest. Endosc., vol. 6, no. 1, pp. 6-11, 2004.

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.

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.

J. Rakinic, “Benign anorectal surgery: management,” Adv. Surg., vol. 52, pp. 179-204, 2018.

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.

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.

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.

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.

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.

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.

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.

Downloads

Download data is not yet available.

##plugins.themes.bootstrap3.article.details##

How to Cite
Soeseno, S. W., Wahyudi, P. A. E., & Febyan, F. (2021). Diagnosis and Management of Internal Hemorrhoids: A Brief Review. European Journal of Medical and Health Sciences, 3(5), 1–5. https://doi.org/10.24018/ejmed.2021.3.5.1014