Hemorrhoidal disease: a very common medical condition in the general population

“Hemorrhoids have long been recognized as a disease entity, the first historical trace going back to Ancient Egypt. Yet, despite this long history, much concerning hemorrhoidal disease remains unclear. Its admittedly complex pathophysiology, for instance, is incompletely elucidated. Nonetheless, over the last 20 years, conceptual advances as well as the refinement of treatment strategies have been driven by learned societies and by many consensus conferences, which have yielded recommendations and practical advice. Certain innovative concepts – such as hemorrhoidopexy – have led to a review of the therapeutic approach. In minimally invasive surgery, hemorrhoidal disease has been the subject of a good many high-level randomized studies, many more, in fact, than some treatments deemed definitive, such as appendectomy!

These more recent strategies place the patient at the heart of decision making. Evidence-based medicine includes, in the “right” decision, the scientific data, of course, but also the practitioner’s experience and the patient’s wishes. The former is especially important in mastering various instrumental and surgical techniques. The best technique is that over which the physician has complete mastery, both technically and in terms of its indications and contraindications.”(…)

Medicographia n°139

Hemorrhoids: an update from pathophysiology to clinical management