Innere Medizin: Offener Zugang
Offener Zugang

Abstrakt

Haemorrhoids-Current Management Overview

Joji N and Buchanan GN*

Symptomatic haemorrhoidal disease is a common ailment in the western world. Common symptoms are bright red bleeding, pruritus, hygiene issues and prolapse. Visual inspection and digital rectal examination usually confirm the diagnosis, assisted by procto-sigmoidoscopy to evaluate the internal extent. Management options range from conservative measures to a variety of outpatient and surgical procedures. Outpatient treatments include injection sclerotherapy, rubber band ligation (RBL). Surgical options include hemorrhoid excision, Doppler guided ligation of the feeding haemorrhoidal vessels by haemorrhoidal artery ligation operation (HALO), transanal haemorrhoidal dearterialisation (THD) or stapled haemorrhoidopexy. Excision is usually the treatment of choice where haemorrhoids are irreducible and largely external, or particularly where there is a large skin tag element. There is an increasing trend towards minimally invasive treatment methods which aim to not only preserve function but enable an enhanced recovery.