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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