Materiały źródłowe

• #1 Hemorrhoids: Diagnosis and Treatment Options | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0201/p172.html

  Many Americans between 45 and 65 years of age experience hemorrhoids. […] Medical management (e.g., stool softeners, topical over-the-counter preparations, topical nitroglycerine), dietary modifications (e.g., increased fiber and water intake), and behavioral therapies (sitz baths) are the mainstays of initial therapy. […] If these are unsuccessful, office-based treatment of grades I to III internal hemorrhoids with rubber band ligation is the preferred next step because it has a lower failure rate than infrared photocoagulation. […] Open or closed (conventional) excisional hemorrhoidectomy leads to greater surgical success rates but also incurs more pain and a prolonged recovery than office-based procedures; therefore, hemorrhoidectomy should be reserved for recurrent or higher-grade disease.

• #1 Hemorrhoids: Diagnosis and Treatment Options | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0201/p172.html

  Closed hemorrhoidectomy with diathermic or ultrasonic cutting devices may decrease bleeding and pain. […] Stapled hemorrhoidopexy elevates grade III or IV hemorrhoids to their normal anatomic position by removing a band of proximal mucosal tissue; however, this procedure has several potential postoperative complications. […] Hemorrhoidal artery ligation may be useful in grade II or III hemorrhoids because patients may experience less pain and recover more quickly. […] Excision of thrombosed external hemorrhoids can greatly reduce pain if performed within the first two to three days of symptoms. […] First-line conservative treatment of hemorrhoids consists of a high-fiber diet (25 to 35 g per day), fiber supplementation, increased water intake, warm water (sitz) baths, and stool softeners.

• #1 Hemorrhoids and what to do about them – Harvard Health

  https://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them

  Hemorrhoids can usually be diagnosed from a simple medical history and physical exam. […] Dramatic relief for most hemorrhoid symptoms can be found with simple, home remedies for hemorrhoids. […] To avoid occasional flare-ups, try the following. […] Get more fiber. Add more fiber to your diet from food, a fiber supplement (such as Metamucil, Citrucel, or Fiber Con), or both. […] High-fiber foods include broccoli, beans, wheat and oat bran, whole-grain foods, and fresh fruit. […] Fiber supplements help decrease hemorrhoidal bleeding, inflammation, and enlargement. […] Moderate aerobic exercise, such as brisk walking 2030 minutes a day, can help stimulate bowel function. […] A sitz bath is a warm water bath for the buttocks and hips. […] Over-the-counter hemorrhoid creams containing a local anesthetic can temporarily soothe pain.

• #1 Hemorrhoids – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268

  Hemorrhoids can develop from increased pressure in the lower rectum due to: […] There are several options available to treat hemorrhoids. Many people get relief with home treatments and lifestyle changes. […] To prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips: […] Studies have shown that nonprescription fiber supplements, such as psyllium (Metamucil, Konsyl, others) or methylcellulose (Citrucel), can lessen symptoms and bleeding from hemorrhoids. […] If you have bleeding during bowel movements or you have hemorrhoids that don’t improve after a week of home care, talk to your health care provider.

• #1 Home Treatment and Remedies for Hemorrhoid Relief

  https://www.webmd.com/digestive-disorders/hemorrrhoid-home-care

  If you’re struggling with hemorrhoids, you may not need to see a doctor for quick ways to ease your itching and pain or for ongoing help to keep the discomfort from getting worse. The best treatments for hemorrhoids are often things you can do at home. […] Many of these tips will help you avoid constipation and make it easier to go. That can stop hemorrhoids before they form, too. […] Rub on relief. Over-the-counter wipes or creams with lidocaine or witch hazel can soothe pain and itch with no side effects. Don’t use one with hydrocortisone for more than a week unless your doctor says it’s OK. […] You can apply hemorrhoid cream up to four times a day to ease symptoms. […] Ice it. Put a small cold pack on the trouble spot several times a day for 5 to 10 minutes at a time. It can dull pain and bring down the swelling for a little while.

• #1 Hemorrhoid Treatment: Home Remedies & Medical Options

  https://www.templehealth.org/about/blog/how-can-i-treat-my-hemorrhoids

  Don’t sit too long on the toilet this engorges the hemorrhoidal veins and can make the situation worse. […] Avoid sitting for long periods while everyone knows that pregnancy increases the risk of having hemorrhoids, sitting for a long time (like long distance truck drivers) can increase hemorrhoids, too. […] Use ointments, creams and suppositories these can help in several ways. Most of them contain emollients medications to soften and soothe the skin. […] However, sometimes these remedies do not work, or don’t work well enough. In that case, there are treatments that the doctor can provide. These can range from pills to prescription creams to minimally invasive procedures, and even to hemorrhoid removal surgery.

• #1 Piles (haemorrhoids)

  https://www.nhs.uk/conditions/piles-haemorrhoids/

  Piles (haemorrhoids) are lumps inside and around your bottom (anus). They often get better on their own after a few days. There are things you can do to treat and prevent piles. […] How you can treat or prevent piles […] drink lots of fluid and eat plenty of fibre to keep your poo soft […] take paracetamol if piles hurt […] take a warm bath to ease itching and pain […] use an ice pack wrapped in a towel to ease discomfort […] gently push a pile back inside […] keep your bottom clean and dry […] exercise regularly […] cut down on alcohol and caffeine (like tea, coffee and cola) to avoid constipation. […] A pharmacist can suggest creams to ease the pain, itching and swelling […] treatment to help constipation and soften poo […] cold packs to ease discomfort. […] If there’s no improvement to your piles after home treatments, you may need hospital treatment.

• #1 Hemorrhoids: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/hemorrhoids/treatment

  Anal wipes. These help with pain, itching, and dryness. You must gently clean and dry the area before you use them. […] Witch hazel. This dries and tightens the skin around the anus. You can use witch hazel after you’ve had a bowel movement. It comes in liquid, pad, and wipe form. […] Steroid creams. Hydrocortisone creams like Preparation H hydrocortisone reduce swelling and pain caused by hemorrhoids. Don’t use these creams for longer than two weeks consecutively. […] Phenylephrine ointments or suppositories. These remedies, like Preparation H or Rectacaine, temporarily shrink swollen hemorrhoids and relieve itching and discomfort. […] Numbing ointments. Benzocaine, dibucaine, and lidocaine rectal ointments can all help with pain and itching but should be used only occasionally, in small amounts. Talk to your doctor before you use them.

• #1 List of 49 Hemorrhoids Medications Compared

  https://www.drugs.com/condition/hemorrhoids.html

  Hemorrhoids are painful, swollen veins in the lower portion of the rectum or anus. […] The medications listed below are related to or used in the treatment of this condition. […] hydrocortisone to treat Hemorrhoids […] Anucort-HC to treat Hemorrhoids […] Preparation H Maximum Strength to treat Hemorrhoids […] Proctozone HC to treat Hemorrhoids […] Proctofoam HC to treat Hemorrhoids […] Anusol-HC Suppositories to treat Hemorrhoids […] Analpram-HC to treat Hemorrhoids […] lidocaine to treat Hemorrhoids […] hydrocortisone / pramoxine to treat Hemorrhoids […] Procto-Med HC to treat Hemorrhoids […] hydrocortisone / lidocaine to treat Hemorrhoids […] Preparation H Anti-Itch Cream Hydrocortisone 1% […] pramoxine to treat Hemorrhoids […] phenylephrine to treat Hemorrhoids […] dibucaine to treat Hemorrhoids […] LMX 5 to treat Hemorrhoids […] RectiCare to treat Hemorrhoids.

• #1 Home treatment and remedies for hemorrhoid relief

  https://www.medicalnewstoday.com/articles/317114

  Hemorrhoids are are lumps inside and around the anus. Remedies for hemorrhoids can include warm baths, over-the-counter (OTC) medications, and lifestyle changes. […] This article explores several useful home remedies for hemorrhoids, as well as some steps to take to help deal with or avoid hemorrhoids altogether. […] There are many hemorrhoid treatment options available in the home or in the form of OTC medications. Many of the treatment methods involve simply easing the symptoms of the hemorrhoids until they clear up on their own. […] According to the United Kingdoms National Health Service (NHS), sitting in a warm water bath may help to ease the pain and itching hemorrhoids cause. […] Many people apply witch hazel directly to the external hemorrhoids to find relief. […] A 2020 study found that combining a medication called micronized purified flavonoid fraction with an ointment containing witch hazel and other herbal extracts helped to reduce hemorrhoid pain, itching, and swelling.

• #1 Hemorrhoids Treatment, Symptoms, Causes & Prevention

  https://my.clevelandclinic.org/health/diseases/15120-hemorrhoids

  Hemorrhoids often go away on their own without treatment. Symptoms like pain and bleeding may last one week or slightly longer. In the meantime, you can take these steps to ease symptoms: Apply over-the-counter medications containing lidocaine, witch hazel or hydrocortisone to the affected area. Drink more water. Increase fiber intake through diet and supplements. Try to obtain at least 20 to 35 grams of daily fiber intake. Soak in a warm bath (sitz bath) for 10 to 20 minutes a day. Soften stool by taking laxatives. Take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation. Use toilet paper with lotion or flushable wet wipes to gently pat and clean your bottom after pooping. You can also use a tissue or washcloth moistened with water. (Discard wipes in the trash, not by flushing. Launder washcloths separately in hot water to avoid spreading infections often found in poop.)

• #1 Hemorrhoid Treatment for Internal, External, or Bleeding Hemorrhoids

  https://www.webmd.com/digestive-disorders/understanding-hemorrhoids-treatment-medref

  Hemorrhoids almost always get better on their own. You can usually get relief from the itching, swelling, and pain with some simple lifestyle changes that help keep you from getting constipated, such as eating more fiber and drinking more water. […] To soothe the pain and itching of hemorrhoids, try these tips: Eat more fiber. A high-fiber diet is one of the best ways to treat your hemorrhoids. A diet that includes a lot of high-fiber foods can help keep your poop softer and easier to pass. […] Take fiber supplements if you can’t get enough fiber from food. Doctors recommend fiber supplements with psyllium (Metamucil) or methylcellulose (Citrucel). […] Stay hydrated. This is another way you can help prevent constipation and the need to strain when you poop. […] Use soothing wipes to clean yourself after you poop.

• #1 Hemorrhoids: Diagnosis and Treatment Options | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0201/p172.html

  There are multiple topical over-the-counter hemorrhoid remedies. […] Prescription therapies may also be part of first-line treatment. […] Office-based and surgical procedures can effectively treat hemorrhoids refractory to medical therapies. […] The primary office-based procedures to treat grade I to III internal hemorrhoids include banding and infrared photocoagulation. […] When the two methods are compared, long-term success favors rubber band ligation, whereas pain improvement is greater with infrared photocoagulation. […] Surgical excision is primarily accomplished through closed hemorrhoidectomy (mucosal defect typically closed; the most common technique in the United States) or open hemorrhoidectomy (removal of hemorrhoidal tissue with mucosal defect left open). […] Conventional hemorrhoidectomy has been modified to include two alternative energy devices, Ligasure and Harmonic Scalpel, which use diathermy and ultrasonic energy, respectively, to limit blood loss and postoperative pain as the instruments cut through tissue.

• #1 Hemorrhoids Treatment & Management: Approach Considerations, Emergency Department Care, Conservative Management

  https://emedicine.medscape.com/article/775407-treatment

  Rubber band ligation is the most-used remedy for grade II and grade III hemorrhoids and is the standard by which other methods are compared. […] Surgical hemorrhoidectomy is the most effective treatment for all hemorrhoids and in particular is indicated in the following situations: Conservative or nonsurgical treatment fails (persistent bleeding or chronic symptoms) […] About 5-10% of people with hemorrhoids eventually require surgical hemorrhoidectomy. […] Nonlaser versus laser hemorrhoidectomy […] Stapled hemorrhoid surgery, or PPH, was first described in 1997-1998 and has become prominent. […] Doppler-guided transanal hemorrhoidal dearterialization (THD Doppler) appears to be a promising procedure in the treatment of hemorrhoids. […] Hemorrhoidal artery ligation (HAL) and rectoanal repair (RAR) (HAL with mucopexy) are other minimally invasive alternatives to conventional hemorrhoidectomy that show promise for prolonged relief in patients with symptomatic hemorrhoidal disease.

• #1 Piles (haemorrhoids)

  https://www.nhs.uk/conditions/piles-haemorrhoids/

  Common hospital treatments include rubber band ligation: a band is placed around your piles to make them drop off […] sclerotherapy: a liquid is injected into your piles to make them shrink […] electrotherapy: a gentle electric current is applied to your piles to make them shrink […] infrared coagulation: an infrared light is used to cut the blood supply to your piles to make them shrink. […] If these treatments do not work, you may need surgery to remove your piles. […] Surgical treatments include haemorrhoidectomy: your piles are cut out […] stapled haemorrhoidopexy: your piles are stapled back inside your anus […] haemorrhoidal artery ligation: stitches are used to cut the blood supply to your piles to make them shrink.

• #1

  https://fascrs.org/patients/diseases-and-conditions/a-z/hemorrhoids

  If pain from a thrombosed hemorrhoid is severe, your physician may decide to remove the hemorrhoid and/or clot with a small incision. These procedures can be done at your physicians office or at the hospital under local anesthesia. […] Rubber Band Ligation: This treatment works well on internal hemorrhoids that protrude during bowel movements. A small rubber band is placed over the hemorrhoid, cutting off its blood supply. The hemorrhoid and the band fall off in a few days. The wound usually heals in one to two weeks. […] Injection and Coagulation: This method can be used on internal hemorrhoids that do not protrude. Both methods are fairly painless and cause the hemorrhoid to shrivel. Several treatments may be needed. This cannot be used for external hemorrhoids. […] Hemorrhoidectomy: This is the most complete surgical method for removing extra tissue that causes bleeding and protrusion. It is done for both internal and external hemorrhoids under anesthesia using sutures. Depending on the case, hospitalization and a period of rest may be required. Hemorrhoidectomy is considered when: Clots repeatedly form in external hemorrhoids. Ligation is not effective in treating internal hemorrhoids. The protruding hemorrhoid cannot be reduced. There is chronic bleeding.

• #1 Treatment of Hemorrhoids – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/treatment

  You can most often treat your hemorrhoids at home by […] Applying over-the-counter hemorrhoid creams or ointments or using suppositories may relieve mild pain, swelling, and itching of external hemorrhoids. […] Most prolapsed internal hemorrhoids go away without at-home treatment. However, severely prolapsed or bleeding internal hemorrhoids may need medical treatment. […] Doctors treat hemorrhoids with procedures during an office visit or in an outpatient center or a hospital. […] Rubber band ligation is a procedure that doctors use to treat bleeding or prolapsing internal hemorrhoids. […] A doctor injects a solution into an internal hemorrhoid, which causes scar tissue to form. […] A doctor uses a tool that directs infrared light at an internal hemorrhoid. […] A doctor uses a tool that sends an electric current into an internal hemorrhoid.

• #1 Hemorrhoid Ligation: The New, Permanent Treatment for Hemorrhoids | Unio Specialty Care

  https://uniospecialtycare.com/resources/hemorrhoid-ligation-the-new-permanent-treatment-for-hemorrhoids/

  Hemorrhoid ligation is a medical procedure used to treat hemorrhoids, often recommended to patients whose problem does not resolve with at-home treatments. The procedure is minimally invasive, requires no anesthesia, and is considered a permanent cure for hemorrhoids. The swollen veins simply fall off, so they cannot come back. […] Ligation is considered one of the most effective ways to treat hemorrhoids, and it has a success rate of between 60 to 80 percent. Recovery time from this procedure is typically very short, and you can expect to return to your normal activities within two to three days, which is shorter compared to recovery from surgery. […] One of the biggest advantages of ligation is that it offers a permanent solution for most people. Only 5 percent of people who have had the procedure experience a recurrence years after the procedure. Mostly, once a hemorrhoid falls off, it will not grow back – unlike other treatments such as creams or ointments, which only offer temporary relief. Ligation also tends to have fewer complications than other treatments like surgery, as it is minimally invasive. So, if you are looking for a non-surgical way to get rid of hemorrhoids, ligation could be ideal for you. […] At Genensis Healthcare Partners, our board-certified and fellowship-trained gastroenterologists perform hemorrhoid ligation skillfully and with great success. We can help you overcome all your GI issues using state-of-the-art treatments that are painless and quick.

• #1 hemorrhoids Treatments and Procedures – CT Colorectal Center

  http://www.ctcolorectal.com/hemorrhoids-treatments-procedures.php

  Hemorrhoids Treatments and Procedures […] Simple treatment measures done in the surgeons office can be used to manage most cases of symptomatic hemorrhoids. There are several procedures that can be performed depending on the type of hemorrhoids and their location. These treatments include: […] Rubber Band Ligation: This procedure is used with internal hemorrhoids. An elastic band is applied to the hemorrhoid in order to cut off its blood supply. After about a week the hemorrhoid will fall off. The cure rate for this procedure is almost 90%. […] Sclerotherapy: This involves injecting a medicine into the hemorrhoid, which makes it shrink and shrivel up. The success rate is 70% with this treatment. […] Cauterization: There are several cautery methods including: Infrared Coagulation The surgeon uses a device that creates an intense beam of light, which cuts off the blood supply to the hemorrhoid. The hemorrhoid dies and a scar remains. […] Laser Surgery The surgeon uses a laser light with pinpoint accuracy that vaporizes the hemorrhoid. […] Electrocautery A metal probe that is heated by electricity is used to destroy the hemorrhoid.

• #1 Hemorrhoid Treatment for Internal, External, or Bleeding Hemorrhoids

  https://www.webmd.com/digestive-disorders/understanding-hemorrhoids-treatment-medref

  Apply ointments, creams, or lotions made for hemorrhoids. […] Sit in a warm bath (sometimes called a sitz bath). Its a time-honored therapy: Sit in about 3 inches of warm (not hot) water for 15-20 minutes several times a day. […] Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to help ease the pain and inflammation of your hemorrhoids. […] Apply a cold compress. A simple cold pack on the tender area for a few minutes can help numb it and bring down the swelling. […] If your symptoms are serious or aren’t getting better after 1-2 weeks, your doctor may suggest a procedure to help ease your symptoms. Most of these procedures are done on internal hemorrhoids and work to close off the blood supply, which shrinks and removes them. […] Procedures your doctor may suggest include: Sclerotherapy. During this procedure, your doctor injects your hemorrhoid with a solution that closes off the blood supply.

• #1

  https://www.singhealth.com.sg/patient-care/conditions-treatments/haemorrhoids-piles

  Haemorrhoids (Piles) – Treatments […] The treatment of haemorrhoids depends on the severity and the type of symptoms affecting the patient. […] Simple preventive measures include having a balanced diet and adequate water intake to allow regular bowel movement without straining. If this does not help, other treatments available include: […] Oral medications or topical suppositories can be used to treat small bleeding haemorrhoids. […] Ligation is a rubber band treatment that works effectively on internal haemorrhoids that protrude with bowel movements. A small rubber band is placed over the haemorrhoid, cutting off its blood supply. The haemorrhoid and the band fall off in a few days and the wound usually heals in a week or two. This procedure sometimes produces mild discomfort and bleeding. […] For this procedure, the doctor injects a chemical solution into the haemorrhoid, causing it to shrivel and subsequently fall off. This method is relatively painless and can also be used on bleeding haemorrhoids that don’t protrude.

• #1 Hemorrhoids Treatment, Symptoms, Causes & Prevention

  https://my.clevelandclinic.org/health/diseases/15120-hemorrhoids

  You should see your healthcare provider if symptoms get worse or interfere with your daily life or sleep. Also, seek help if signs dont improve after a week of at-home treatments. Your provider may treat hemorrhoids with: Rubber band ligation: A small rubber band placed around the base of a hemorrhoid cuts off blood supply to the vein. Electrocoagulation: An electric current stops blood flow to a hemorrhoid. Infrared coagulation: A small probe inserted into the rectum transmits heat to get rid of the hemorrhoid. Sclerotherapy: A chemical injected into the swollen vein destroys hemorrhoid tissue. […] Surgical treatments include: Hemorrhoidectomy: Surgery removes large external hemorrhoids or prolapsed internal ones. Hemorrhoid stapling: A stapling instrument removes an internal hemorrhoid. Or it pulls a prolapsed internal hemorrhoid back inside of your anus and holds it there.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Banding-Sclerotherapy-and-Electrotherapy-for-Piles-(Haemorrhoids).aspx

  Piles often exist without causing any problems and people may not realise they have them. […] The symptoms of hemorroids often clear up spontaneously or with the use of simple treatments such as dietary changes and/or the use of creams and suppositories that relieve discomfort and swelling. However, severe piles may require more intensive treatment. […] For piles located in the upper two thirds of the canal, however, non-surgical procedures can be used, such as banding, sclerotherapy and electrotherapy. […] Banding refers to the placement of a tight elastic band around the base of the pile to cut off its blood supply. […] Sclerotherapy is commonly prescribed when people fail to respond to hemorrhoid treatments or when hemorrhoids cannot be treated with banding. […] Also called electrocoagulation, this procedure uses an electric current to destroy the pile.

• #1 Non-surgical haemorrhoid treatments – eXroid

  https://www.exroid.com/haemorrhoid-advice/non-surgical-haemorrhoid-treatments

  Haemorrhoid Treatment […] Understand how the eXroid® Treatment works. […] eXroid’s at home haemorrhoid treatment. […] eXroid® electrotherapy is a highly effective treatment for piles. […] Half of patients were cleared of their haemorrhoid after one treatment session, and over 80% after two. […] eXroid® electrotherapy for haemorrhoids is an outpatient treatment and requires no anaesthetic. […] After noting its effectiveness and low complication rate, NICE published positive guidance for electrotherapy hemorrhoid treatment through Interventional Procedure Guidance (IPG) 525 in June 2015. […] Haemorrhoid electrotherapy may require more than one treatment; however, about half of the patients treated are free of symptoms after one treatment session, and over 80% after two. […] Electrotherapy for haemorrhoids causes less discomfort and less side effects than generally reported figures in the literature compared with banding or higher current electrotherapy, which suggests that it is likely to be one of the best tolerated non-surgical procedures available. […] eXroid® is no exception—there are some risks with even the safest and most effective treatment. […] The procedure has been proven to be virtually complication free. […] Rubber band ligation, also called banding, involves the application of a tight elastic band around the base of the haemorrhoid which cuts off the blood supply and results in the haemorrhoid dropping off after typically 10-14 days. […] The procedure itself takes a few minutes depending on the number of haemorrhoids, though it is generally accepted that no more than two at a time should be treated in order to minimise discomfort and the risk of bleeding. […] Sclerotherapy is the injection of a chemical solution into the area around the haemorrhoid resulting in a scarring reaction which makes the haemorrhoid gradually shrink or shrivel up over time. […] The treatment typically takes 5-10 minutes and 2-3 haemorrhoids can be treated at one time. […] There are less common non-surgical treatments available, including injection sclerotherapy, various forms of heat generating treatment including: infrared coagulation (IRC), radiofrequency (Rafaelo), AC electrotherapy (HET) and laser therapy.

• #1 Hemorrhoids Treatment & Management: Approach Considerations, Emergency Department Care, Conservative Management

  https://emedicine.medscape.com/article/775407-treatment

  The following is a quick summary of treatment for internal hemorrhoids by grade: Grade I hemorrhoids are treated with conservative medical therapy and avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) and spicy or fatty foods […] Grade II or III hemorrhoids are initially treated with nonsurgical procedures […] Very symptomatic grade III and grade IV hemorrhoids are best treated with surgical hemorrhoidectomy […] Treatment of grade IV internal hemorrhoids or any incarcerated or gangrenous tissue requires prompt surgical consultation. […] Stapled hemorrhoid surgery, or procedure for prolapsing hemorrhoids (PPH), is an excellent alternative for treating internal hemorrhoids that have not been amenable to conservative or nonoperative approaches. […] External hemorrhoid symptoms are generally divided into problems with acute thrombosis and hygiene/skin tag complaints. The former respond well to office excision (not enucleation), whereas operative resection is reserved for the latter.

• #1 Hemorrhoid Treatment for Internal, External, or Bleeding Hemorrhoids

  https://www.webmd.com/digestive-disorders/understanding-hemorrhoids-treatment-medref

  Rubber band ligation. This procedure is often done on prolapsed (those that have pushed outside your anus) internal hemorrhoids. […] Infrared photocoagulation. In this procedure, your doctor uses a tool to direct infrared light at your hemorrhoid. […] Electrocauterization. With an electric probe, your doctor makes a tiny burn to remove tissue and seal the end of the hemorrhoid, causing it to close off and shrink. […] You may be able to soothe the itching, pain, and swelling of your external hemorrhoids with creams, ointments, or suppositories (medicine you put in your rectum) made for hemorrhoids. […] Most people don’t need surgery to remove hemorrhoids. However, if other approaches haven’t helped or if you have large hemorrhoids, your doctor may recommend surgery, using one of the following procedures: Hemorrhoidectomy (hemorrhoid removal). This is the most effective way to treat large external or prolapsing internal hemorrhoids or those that keep coming back. […] Hemorrhoidopexy (hemorrhoid stapling). This is usually only used for internal hemorrhoids. It cuts off blood flow to your hemorrhoids and also moves prolapsed tissue back in place.

• #1 Hemorrhoids Treatment & Management: Approach Considerations, Emergency Department Care, Conservative Management

  https://emedicine.medscape.com/article/775407-treatment

  When performed well, operative hemorrhoidectomy should have a 2-5% recurrence rate. Nonoperative techniques, such as rubber band ligation, produce recurrence rates of 30-50% within 5-10 years. […] The major controversies regarding the treatment of hemorrhoids center on the indications for treatment and the choice of operative versus nonoperative therapy. […] Medical management is the initial treatment of choice for grade I internal and nonthrombosed external hemorrhoids. […] Many patients see improvement or complete resolution of their symptoms with conservative measures. Aggressive therapy is reserved for patients who have persistent symptoms after 1 month of conservative therapy. […] Numerous nonoperative methods to destroy internal hemorrhoids are available. Nonsurgical techniques function by rubber band ligation, ablation, sclerosis, or necrosis of mucosal tissues.

• #1 hemorrhoids Treatments and Procedures – CT Colorectal Center

  http://www.ctcolorectal.com/hemorrhoids-treatments-procedures.php

  Often medically managing hemorrhoids will give you relief and there are several non-surgical treatments also available (mentioned above). However, sometime its necessary to perform surgery. The type of surgery performed is called a hemorrhoidectomy, which means excising (cutting) the hemorrhoid and removing it. This can be done using a local anesthetic, which means the area to be operated on is numbed so you wont feel any pain, but you are awake during the procedure or it can be done using general anesthesia and you are asleep during the entire procedure. Frequently this is done on an outpatient basis, and you can go home the same day you have the surgery. Usually surgery provides relief for the pain and swelling, but since stitches may be required, that area will be painful and sensitive until healing occurs. Pain medication, Sitz baths, and taking stool softeners will help you manage the pain as you recover. However, dont take any pain medication without your surgeons approval. Recovery time may be from two to six weeks.

• #1 Hemorrhoids and what to do about them – Harvard Health

  https://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them

  When an external hemorrhoid forms a blood clot, the pain can be excruciating. […] If the clot is more recent, the hemorrhoid can be surgically removed or the clot withdrawn from the vein in a minor office procedure performed by a surgeon. […] Some hemorrhoids can’t be managed with conservative treatments alone, either because symptoms persist or because an internal hemorrhoid has prolapsed. […] The most commonly used hemorrhoid treatment in the United States is rubber band ligation, in which a small elastic band is placed around the base of a hemorrhoid. […] You may need surgery if you have large protruding hemorrhoids, persistently symptomatic external hemorrhoids, or internal hemorrhoids that return despite rubber band ligation. […] In a traditional hemorrhoidectomy, a narrow incision is made around both external and internal hemorrhoid tissue and the offending blood vessels are removed. […] An alternative to traditional hemorrhoidectomy is called stapled hemorrhoidopexy.

• #1 hemorrhoids Treatments and Procedures – CT Colorectal Center

  http://www.ctcolorectal.com/hemorrhoids-treatments-procedures.php

  Sometimes hemorrhoids will prolapse. Prolapse means to fall out. These are internal hemorrhoids that have become so stretched that they protrude outside the anus. When this occurs, a procedure called PPH (Procedure for Prolapsing Hemorrhoids) is usually performed. Excess tissue is removed and the remaining hemorrhoidal tissue is stapled, which restores the hemorrhoids back to their original position and cuts off their blood supply. Without a supply of blood, the hemorrhoids shrivel up and die.

• #1

  https://www.singhealth.com.sg/patient-care/conditions-treatments/haemorrhoids-piles

  Haemorrhoids that are not prolapsed can be ligated or injected. These are simple procedures that can be done in an outpatient clinic and do not require hospitalisation. But these procedures may not be extremely effective, and may require more than one treatment. […] More definitive measures are needed for severe cases, such as when clots repeatedly form in external haemorrhoids, or ligation fails to treat internal haemorrhoids, or when a protruding haemorrhoid cannot be reduced, or when there is persistent bleeding. […] Surgical techniques under general anaesthesia include: […] Haemorrhoidectomy is surgery to remove excessive tissue causing the bleeding and protrusion. It is the best method for the permanent removal of large, prolapsed haemorrhoids. Haemorrhoidectomy can be performed in the conventional manner, or through stapled haemorrhoidectomy. This is a form of surgery performed under general anaesthesia. A device is used to excise the haemorrhoids internally and the internal wound is closed via a row of „staples”. Compared to the conventional „open” method of haemorrhoidectomy, where there is a raw wound, stapled haemorrhoidectomy causes less discomfort and a shorter duration of pain to the patient in the immediate postoperative period. It’s effective in treating large haemorrhoids that protrude from the anus during defecation. […] Transanal haemorrhoidal dearterialisation (THD) involves using an ultrasound to locate the problematic blood vessels and stitching the haemorrhoids. As methods may vary slightly from person to person, patients are advised to consult their surgeons to figure out the right treatment for them.

• #1 Hemorrhoids: The Definitive Guide to Medical and Surgical Treatment

  https://consultqd.clevelandclinic.org/hemorrhoids-the-definitive-guide-to-medical-and-surgical-treatment

  Office-based treatments rubber band ligation, infrared photocoagulation, and sclerotherapy are commonly used for grade I, II and III hemorrhoids that have not responded to conservative management. […] Although nonsurgical treatments have substantially improved, surgery is the most effective and strongly recommended treatment for patients with high-grade internal hemorrhoids (grades III and IV), external and mixed hemorrhoids, and recurrent hemorrhoids. […] The most popular surgical options are open or closed hemorrhoidectomy, stapled hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation. […] Overall, surgery is associated with more adverse effects than office-based treatments or medical management. […] Excisional hemorrhoidectomy can be performed using either an open approach, in which the edges of the mucosal defect are not reapproximated, or a closed approach, in which they are.

• #1 5 common causes of haemorrhoids and treatment options | King Edward VII’s Hospital

  https://www.kingedwardvii.co.uk/health-hub/haemorrhoids-causes-symptoms-treatment-options

  In some severe cases, Rafaelo may not be able to help and you may need surgery (such as a haemorrhoidectomy or haemorrhoid stapling). […] Mr Amyn Haji is a specialist colorectal surgeon. He has particular expertise in haemorrhoids, offering minimally-invasive surgical treatment options, including the Rafaelo procedure and haemorrhoidectomy. He and the colorectal team at King Edward VII’s Hospital can provide expert treatment, advice and guidance.

• #1 Hemorrhoids (Internal, External): Symptoms, Causes, Treatment

  https://www.medicinenet.com/hemorrhoids_piles/article.htm

  What is the treatment for hemorrhoids? […] Once hemorrhoidal symptoms develop, a variety of treatment options exist, depending upon the situation and severity of the hemorrhoids. However, regardless of the size or swelling of a hemorrhoid, no treatment is required if symptoms do not exist. […] Grade 1 hemorrhoids are treated symptomatically. There can be some spasms of the anal muscles. Warm sitz baths, sitting in a warm tub for 20 minutes two or three times a day may be helpful. Avoiding spicy food may also prevent anal itching. Over-the-counter hemorrhoid medications may be helpful. […] Grade 2 and 3 hemorrhoids are initially treated the same way, using techniques to destroy hemorrhoids. These include: injecting the hemorrhoid vein to make it sclerose or harden, using rubber bands to choke off the blood supply and make the hemorrhoidal tissue shrivel, and other procedures that cause the mucosa to shrivel and die.

• #1 Treatment of hemorrhoids: A coloproctologist’s view

  https://www.wjgnet.com/1007-9327/full/v21/i31/9245.htm

  Treatment options mainly depend on the type and severity of hemorrhoids, patients preference and the expertise of physicians. Low-graded internal hemorrhoids are effectively treated with dietary and lifestyle modification, medical treatment and/or office-based procedures such as rubber band ligation and sclerotherapy. An operation is usually indicated in low-graded hemorrhoids refractory to non-surgical treatment, high-graded hemorrhoids, and strangulated hemorrhoids. […] Surgical intervention is usually required in low-graded hemorrhoids refractory to non-surgical treatment, high-graded symptomatic hemorrhoids, and hemorrhoids with complication such as strangulation and thrombosis. An operation for hemorrhoids may be performed if patient has other concomitant anorectal conditions requiring surgery, or due to patients preference.

• #1 Treatment of hemorrhoids: A coloproctologist’s view

  https://www.wjgnet.com/1007-9327/full/v21/i31/9245.htm

  Non-excisional operation for hemorrhoids includes doppler-guided hemorrhoidal artery ligation (DG-HAL) or known as transanal hemorrhoidal dearterialization (THD), and plication of hemorrhoids (or known as ligation anopexy or mucopexy). DG-HAL has been introduced into a surgical practice to cut off the blood supply to hemorrhoids without the need of hemorrhoid removal. […] Stapled hemorrhoidopexy, also known as a procedure for prolapse and hemorrhoids (PPH), is an alternative operation for treating advanced internal hemorrhoids. A circular staple device is used to excise a ring of redundant rectal mucosa just above hemorrhoid bundles – not hemorrhoids per se. […] In conclusion, the better understanding of the pathophysiology of hemorrhoids would prompt the development of effective treatments for hemorrhoids. Preventive measures, by means of dietary and lifestyle modification, may be the best treatment of hemorrhoids. Once hemorrhoids develop, its treatment options mainly depend on the type and severity of hemorrhoids, patients preference and the expertise of physicians. Post-procedural pain and disease recurrence remain the most challenging problems in the treatment of hemorrhoids.

• #1 Embolization Is a New Treatment Option for Hemorrhoids | UNC Health Talkhealth wellnessstethoscopeStorieshealth wellnessstethoscopeStoriestwitter-iconfacebook-iconpinterest-iconemail-iconhealth wellnessstethoscopeStoriesfacebooktwitteryoutubepinterestinst

  https://healthtalk.unchealthcare.org/embolization-is-a-new-treatment-option-for-hemorrhoids/

  Embolization Is a New Treatment Option for Hemorrhoids […] The emborrhoid technique, or hemorrhoid embolization, is a real game changer. […] Based on the good results presented in the research and his consultation with UNC Health interventional radiologist David Mauro, MD, he pursued the minimally invasive outpatient procedure. […] Some hemorrhoids go away on their own. You can treat hemorrhoids with topical medications and with high-fiber diets that promote soft stools, decreasing the need to strain during bowel movements. Prolapsed hemorrhoids and hemorrhoids that cause bleeding, however, often require medical treatment. Standard treatments include nonsurgical procedures that use banding around the hemorrhoids or cauterization of the hemorrhoids to cut off blood supply, and surgical removal for advanced hemorrhoids.

• #1 Hemorrhoid Embolization, HAE: Internal Hemorrhoid Treatment azura-logo-white

  https://www.azuravascularcare.com/medical-services/hae/

  Hemorrhoids are swollen, enlarged veins that form inside and outside the anus and rectum. Also known as piles, they can be painful and cause rectal bleeding. […] Many treatment options are available for hemorrhoids, including over-the-counter remedies, surgical procedures, and minimally invasive options. […] If you have internal and/or external hemorrhoids, an Azura Vascular Care center may be able to help with Hemorrhoid Artery Embolization (HAE). During this procedure, a special doctor, called an interventional radiologist, uses x-ray guidance to insert a catheter through your upper leg or wrist and into the arteries that are connected to the hemorrhoids. Tiny coils are released through the catheter to block the arteries supplying blood to the hemorrhoid. This procedure can help alleviate pain and bleeding associated with the condition. HAE is painless and requires virtually no recovery time.

• #1 Hemorrhoid Embolization, HAE: Internal Hemorrhoid Treatment azura-logo-white

  https://www.azuravascularcare.com/medical-services/hae/

  If you are not a candidate for this procedure, there may be surgical options available to you by your gastroenterologist or surgeon. […] About 93% of patients see improvement in hemorrhoid-related symptoms without additional treatment within one month of HAE. […] You may be a candidate for hemorrhoid artery embolization if you: Have been diagnosed with internal and/or external hemorrhoids, Are experiencing symptoms like rectal bleeding and pain for at least 3 months, Have tried other treatments (e.g. sclerotherapy, banding) that have not worked, Want to avoid surgery to treat your hemorrhoids. […] About 93% of patients see improvement in hemorrhoid-related symptoms without additional treatment within one month of hemorrhoid artery embolization. […] Most health insurance plans cover hemorrhoid artery embolization for patients experiencing symptomatic hemorrhoids.

• #1 5 common causes of haemorrhoids and treatment options | King Edward VII’s Hospital

  https://www.kingedwardvii.co.uk/health-hub/haemorrhoids-causes-symptoms-treatment-options

  If your haemorrhoids are particularly painful and don’t go away, you may be recommended rubber band ligation or infrafred coagulation therapy. Rubber band ligation involves tying the base of an internal haemorrhoid with a rubber band to cut off blood supply. […] In recent years, great technological advancements have been made to help treat severe cases of haemorrhoids. We can now offer a revolutionary, effective treatment called the Rafaelo procedure. Rafaelo uses well-established radio frequency technology to help shrink internal haemorrhoids. […] One of the huge benefits of Rafaelo is that it is a fifteen-minute walk-in, walk-out day procedure (you can go home after treatment and return to activities the following day). […] Rafaelo also has a high success rate of 90%, which means it can be a one-off treatment with lasting effects.

• #1

  https://fcaresystems.com/patient-information/haemorrhoids/

  Patients with Grade 2, Grade 3 and some Grade 4 internal haemorrhoids may benefit from Rafaelo, a system developed in 2016 for treating haemorrhoids using high-frequency radio waves. […] The heat from the radio waves causes the pile to shrivel up and scar, but without damaging the healthy tissue around it. […] The whole procedure takes just a few minutes, and most people can return to their usual activities the next day. […] Warm sitz baths or ice packs can alleviate rectal pain and swelling, and there are a variety of creams and ointments on the market as well. […] I needed to try another method to improve my symptoms. Radio frequency ablation with the Rafaelo procedure turned out to be painless and with no side effects. […] I was beyond relieved when my family doctor informed me about radio frequency ablation therapy with Rafaelo, which I found to be incredible.

• #1 Hemorrhoids Medication: Stool softeners, Topical anesthetics, Mild astringent, Analgesics

  https://emedicine.medscape.com/article/775407-medication

  The goals of pharmacotherapy are to reduce pain and constipation in patients with hemorrhoids. […] Docusate is indicated for patients who should avoid straining during defecation. This agent allows incorporation of water and fat into stool, causing stool to soften. […] Topical anesthetic agents are indicated for pain. […] Hamamelis water is a mild astringent prepared from twigs of Hamamelis virginiana. This agent is used to temporarily relieve the itching of hemorrhoids. […] Pain control is essential to quality patient care. Analgesics ensure patient comfort, which is beneficial for patients who have painful lesions. […] Acetaminophen is the drug of choice (DOC) for treatment of pain in patients with documented hypersensitivity to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), with upper gastrointestinal (GI) disease, or who are taking oral anticoagulants.

• #1 Hemorrhoids: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/hemorrhoids/treatment

  There are many options for hemorrhoid treatment, including: […] Your doctor may recommend the following: […] Stool softeners. Docusate sodium (Colace, Docu) is one of the most common stool softeners. This softens bowel movements to help avoid straining while sitting on the toilet. […] Eat more fiber. You should aim for 20 to 35 grams of fiber a day. Fiber prevents constipation, which can worsen hemorrhoids. If getting that much fiber is difficult, try a supplement such as psyllium (Konsyl, Metamucil) or methylcellulose (Citrucel). […] Warm sitz baths. Made with water and a soothing salt, such as mineral bath salts (like Epsom) or sea salts, a sitz bath improves blood flow and relaxes anal muscles. You can find these salts in drugstores. To use them, soak your rectal area in warm water for 10 to 15 minutes, two to three times a day.

• #1 Oral Treatment for Hemorrhoid Relief, Piles Treatment Pills – Hemovel

  https://www.hemovel.com/discover-hemovel

  HEMOVEL is clinically proven to reduce the duration and severity of hemorrhoids and relieves hemorrhoid symptoms, such as pain, swelling and bleeding. […] The HEMOVEL pill helps to reduce the duration and severity of hemorrhoids from the „inside out”, working in the body to relieve symptoms. […] Diosmin has been clinically proven to reduce the duration and severity of hemorrhoids and their symptoms. […] It helps reduce the duration and severity of hemorrhoids and relieves symptoms such as pain, swelling and bleeding. […] As an oral treatment, HEMOVEL helps to reduce the duration and severity of hemorrhoids from the inside out, working in the body to relieve symptoms. […] HEMOVEL’S active ingredient, Diosmin, has a proven track record it has been used in Europe for over 20 years as a trusted treatment for hemorrhoid relief. […] HEMOVEL is clinically proven.

• #1 Hemorrhoids: Which Treatment Should I Use? | HealthLink BC

  https://www.healthlinkbc.ca/healthwise/hemorrhoids-which-treatment-should-i-use

  These treatments cure most small and some large internal hemorrhoids. They aren’t used for external hemorrhoids. They work by cutting off the blood supply to the hemorrhoid, which makes the hemorrhoid shrink or go away. […] Surgery for hemorrhoids is called hemorrhoidectomy. It is the most successful way to treat large internal hemorrhoids. […] Surgery may be a good choice for internal hemorrhoids that bulge from the anus. It is the only choice for external hemorrhoids that are causing symptoms and haven’t improved with home treatment. […] Home treatment works for most people. […] Non-surgical procedures are less risky and less painful than surgery. They require less time off from work and other activities. […] Surgery usually cures a hemorrhoid. But the long-term success of hemorrhoid surgery depends a lot on how well you are able to change your daily bowel habits to avoid constipation and straining. […] Most non-surgical treatments have few risks. […] Surgery is more likely to cause side effects than non-surgical treatments.

• #1 Hemorrhoids (Internal, External): Symptoms, Causes, Treatment

  https://www.medicinenet.com/hemorrhoids_piles/article.htm

  What is the prognosis of hemorrhoids? […] Hemorrhoids are normal tissue and only raise concern when they swell, become inflamed, or bleed. […] Hemorrhoids will recur after nonsurgical treatment about 50% of the time, while the recurrence rate after surgery is only 5%. […] How can you prevent hemorrhoids? […] Prevention is perhaps the most effective treatment. Diet and adequate hydration are very important to maintain normal bowel movements. […] Hemorrhoid symptoms can occur with the passage of hard stool and constipation, as well as diarrhea and frequent bowel movements. […] Frequently asked questions: How to cure hemorrhoids: There is no permanent cure for hemorrhoids. However, adopting a high-fiber diet, proper hydration, regular exercise, warm baths and use of over-the-counter creams and pain medicines may help ease symptoms. […] Less invasive medical procedures such as rubber band ligation or more invasive surgical procedures such as hemorrhoidectomy can help get rid of the existing hemorrhoids, but they do not prevent the formation of new ones.

• #1 Haemorrhoids (piles) | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/haemorrhoids-piles/

  Stapling, also known as stapled haemorrhoidopexy, is an alternative to a conventional haemorrhoidectomy. […] Other treatment options are available, including freezing and laser treatment. However, the number of NHS or private surgeons who perform these treatments is limited. […] Although the risk of serious problems is small, complications can occasionally occur after haemorrhoid surgery. These can include: bleeding or passing blood clots, which may happen a week or so after the operation; infection, which may lead to a build-up of pus (known as an abscess); urinary retention (difficulty emptying your bladder); faecal incontinence (the involuntarily passing of stools); anal fistula (a small channel that develops between the anal canal and surface of the skin, near the anus); stenosis (narrowing of the anal canal).

• #1 Hemorrhoids: The Definitive Guide to Medical and Surgical Treatment

  https://consultqd.clevelandclinic.org/hemorrhoids-the-definitive-guide-to-medical-and-surgical-treatment

  Overall, excisional hemorrhoidectomy is associated with higher pain scores than any other surgical method. […] Doppler-guided hemorrhoidal artery ligation involves using a Doppler probe to find and ligate individual hemorrhoidal arteries. […] There is no best treatment for hemorrhoids. Every patient is different, and the physician and patient need to understand each others expectations, weigh the risks and benefits and arrive at a mutual decision. […] In patients with high-grade, symptomatic hemorrhoids, surgical hemorrhoidectomy is the most effective modality with the lowest recurrence rates, although it causes more pain than conservative methods.

• #1 Hemorrhoids: The Definitive Guide to Medical and Surgical Treatment

  https://consultqd.clevelandclinic.org/hemorrhoids-the-definitive-guide-to-medical-and-surgical-treatment

  Here, we review the process for diagnosing and grading hemorrhoids, as well as for selecting the appropriate medical or surgical treatment based on the most recent clinical evidence. […] In choosing the treatment for hemorrhoids, one should consider the disease grade and severity, its impact on the quality of life, the degree of pain it causes, the patients likelihood of adhering to treatment and the patients personal preference. […] Treatments can be grouped in three categories: conservative, office-based and surgical. Practitioners should thoroughly discuss the options with the patient, emphasizing the pros and cons of each. […] Conservative measures are aimed at softening the stool, relieving pain and correcting bad toileting habits. […] Fiber supplements are strongly recommended in the American Society of Colon and Rectal Surgeons (ASCRS) practice guidelines based on a Cochrane review.

• #1 Hemorrhoids: A range of treatments | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/9/612

  Hemorrhoids are a common reason for office visits. Each patient is unique, and with a range of treatments available, treatment can be individualized. This article reviews the diagnosis and decision-making process for individualized treatment. […] Fiber supplements along with dietary and lifestyle changes are recommended for all patients with hemorrhoids regardless of symptom severity. […] Hemorrhoids are graded on a scale of I (least severe) through IV (most severe). Office-based treatments are effective for grades I, II, and some grade III hemorrhoids. Surgical excision is the standard for high-grade hemorrhoids. […] In choosing the treatment for hemorrhoids, one should consider the disease grade and severity, its impact on the quality of life, the degree of pain it causes, the patients likelihood of adhering to treatment, and the patients personal preference.

• #1 Hemorrhoids: A range of treatments | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/9/612

  Although nonsurgical treatments have substantially improved, surgery is the most effective and strongly recommended treatment for patients with high-grade internal hemorrhoids (grades III and IV), external and mixed hemorrhoids, and recurrent hemorrhoids. […] Overall, excisional hemorrhoidectomy is associated with higher pain scores than any other surgical method. […] Given the variety of available treatments, head-to-head comparisons are difficult. […] Fiber supplements along with dietary and lifestyle changes constitute the baseline of the management regardless of the disease grade. Office-based interventions are beneficial for grade I and II hemorrhoids and for some grade III hemorrhoids. Repeated interventions can increase the success rate. In patients with high-grade, symptomatic hemorrhoids, surgical hemorrhoidectomy is the most effective modality with the lowest recurrence rates, although it causes more pain than conservative methods.

• #2 Hemorrhoids Treatment & Management: Approach Considerations, Emergency Department Care, Conservative Management

  https://emedicine.medscape.com/article/775407-treatment

  Treat hemorrhoids only when the patient complains of them. The old adage that it is hard to make an asymptomatic patient better applies here. No matter how bad the hemorrhoids look to the practitioner, they should not be treated unless they bother the patient. […] Treatment of hemorrhoids is divided by the cause of symptoms, into internal and external treatments. Accurately classifying a patient’s symptoms and the relation of the symptoms to internal and external hemorrhoids is important. […] Internal hemorrhoids do not have cutaneous innervation and can therefore be destroyed without anesthetic, and the treatment may be surgical or nonsurgical. Internal hemorrhoid symptoms often respond to increased fiber and liquid intake and to avoidance of straining and prolonged toilet sitting. Nonoperative therapy works well for symptoms that persist despite the use of conservative therapy. Most nonsurgical procedures currently available are performed in the clinic or ambulatory setting.

• #2 Hemorrhoids: The Definitive Guide to Medical and Surgical Treatment

  https://consultqd.clevelandclinic.org/hemorrhoids-the-definitive-guide-to-medical-and-surgical-treatment

  Here, we review the process for diagnosing and grading hemorrhoids, as well as for selecting the appropriate medical or surgical treatment based on the most recent clinical evidence. […] In choosing the treatment for hemorrhoids, one should consider the disease grade and severity, its impact on the quality of life, the degree of pain it causes, the patients likelihood of adhering to treatment and the patients personal preference. […] Treatments can be grouped in three categories: conservative, office-based and surgical. Practitioners should thoroughly discuss the options with the patient, emphasizing the pros and cons of each. […] Conservative measures are aimed at softening the stool, relieving pain and correcting bad toileting habits. […] Fiber supplements are strongly recommended in the American Society of Colon and Rectal Surgeons (ASCRS) practice guidelines based on a Cochrane review.

• #2 Hemorrhoid Treatment for Internal, External, or Bleeding Hemorrhoids

  https://www.webmd.com/digestive-disorders/understanding-hemorrhoids-treatment-medref

  Hemorrhoids almost always get better on their own. You can usually get relief from the itching, swelling, and pain with some simple lifestyle changes that help keep you from getting constipated, such as eating more fiber and drinking more water. […] To soothe the pain and itching of hemorrhoids, try these tips: Eat more fiber. A high-fiber diet is one of the best ways to treat your hemorrhoids. A diet that includes a lot of high-fiber foods can help keep your poop softer and easier to pass. […] Take fiber supplements if you can’t get enough fiber from food. Doctors recommend fiber supplements with psyllium (Metamucil) or methylcellulose (Citrucel). […] Stay hydrated. This is another way you can help prevent constipation and the need to strain when you poop. […] Use soothing wipes to clean yourself after you poop.

• #2 Hemorrhoids: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/hemorrhoids/treatment

  There are many options for hemorrhoid treatment, including: […] Your doctor may recommend the following: […] Stool softeners. Docusate sodium (Colace, Docu) is one of the most common stool softeners. This softens bowel movements to help avoid straining while sitting on the toilet. […] Eat more fiber. You should aim for 20 to 35 grams of fiber a day. Fiber prevents constipation, which can worsen hemorrhoids. If getting that much fiber is difficult, try a supplement such as psyllium (Konsyl, Metamucil) or methylcellulose (Citrucel). […] Warm sitz baths. Made with water and a soothing salt, such as mineral bath salts (like Epsom) or sea salts, a sitz bath improves blood flow and relaxes anal muscles. You can find these salts in drugstores. To use them, soak your rectal area in warm water for 10 to 15 minutes, two to three times a day.

• #2 Counseling Patients With Hemorrhoids

  https://www.uspharmacist.com/article/counseling-patients-with-hemorrhoids

  Due to the chronic nature of hemorrhoids, the 7-day rule regarding self-therapy means that many patients with hemorrhoidal symptoms will require physician referral when they initially speak to the pharmacist. […] If there are no contraindications, several ingredients and products may provide relief. […] Protectants are useful ingredients due to their ability to form a protective coating over the skin that prevents tissues from drying out; protect irritated areas; relieve burning and skin irritation; protect inflamed, irritated anorectal areas from abrasion and pain during bowel movements; and protect inflamed perianal skin. […] Local anesthetics are not appropriate for internal use, as the mucosal lining of the rectum does not contain sensory nerve fibers. […] Astringents may be used after each bowel movement or as needed, up to 6 times daily.

• #2 Home Treatment and Remedies for Hemorrhoid Relief

  https://www.webmd.com/digestive-disorders/hemorrrhoid-home-care

  If you’re struggling with hemorrhoids, you may not need to see a doctor for quick ways to ease your itching and pain or for ongoing help to keep the discomfort from getting worse. The best treatments for hemorrhoids are often things you can do at home. […] Many of these tips will help you avoid constipation and make it easier to go. That can stop hemorrhoids before they form, too. […] Rub on relief. Over-the-counter wipes or creams with lidocaine or witch hazel can soothe pain and itch with no side effects. Don’t use one with hydrocortisone for more than a week unless your doctor says it’s OK. […] You can apply hemorrhoid cream up to four times a day to ease symptoms. […] Ice it. Put a small cold pack on the trouble spot several times a day for 5 to 10 minutes at a time. It can dull pain and bring down the swelling for a little while.

• #2 External hemorrhoids: Treatment, pictures, symptoms, and causes

  https://www.medicalnewstoday.com/articles/322732

  External hemorrhoids usually do not require a specific treatment unless they develop a clot and become painful. Most will go away on their own within a few days. Those that persist may cause discomfort, itching, and some pain. Home remedies can be effective in easing these symptoms. […] Doctors can sometimes treat external hemorrhoids that develop a clot through surgery. […] The first involves making a small cut in a thrombosed external hemorrhoid and draining blood from the clot. A doctor can perform this surgery under local anesthesia. This procedure does not remove the hemorrhoid itself. However, if a doctor can perform this procedure within 48 hours of a hemorrhoid developing, it can provide more rapid pain relief than other treatments. […] The second form of surgery is a hemorrhoidectomy. This procedure fully removes the hemorrhoid and requires general anesthesia.

• #2 Hemorrhoids: The Definitive Guide to Medical and Surgical Treatment

  https://consultqd.clevelandclinic.org/hemorrhoids-the-definitive-guide-to-medical-and-surgical-treatment

  Office-based treatments rubber band ligation, infrared photocoagulation, and sclerotherapy are commonly used for grade I, II and III hemorrhoids that have not responded to conservative management. […] Although nonsurgical treatments have substantially improved, surgery is the most effective and strongly recommended treatment for patients with high-grade internal hemorrhoids (grades III and IV), external and mixed hemorrhoids, and recurrent hemorrhoids. […] The most popular surgical options are open or closed hemorrhoidectomy, stapled hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation. […] Overall, surgery is associated with more adverse effects than office-based treatments or medical management. […] Excisional hemorrhoidectomy can be performed using either an open approach, in which the edges of the mucosal defect are not reapproximated, or a closed approach, in which they are.

• #2 Hemorrhoids Treatment & Management: Approach Considerations, Emergency Department Care, Conservative Management

  https://emedicine.medscape.com/article/775407-treatment

  The following is a quick summary of treatment for internal hemorrhoids by grade: Grade I hemorrhoids are treated with conservative medical therapy and avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) and spicy or fatty foods […] Grade II or III hemorrhoids are initially treated with nonsurgical procedures […] Very symptomatic grade III and grade IV hemorrhoids are best treated with surgical hemorrhoidectomy […] Treatment of grade IV internal hemorrhoids or any incarcerated or gangrenous tissue requires prompt surgical consultation. […] Stapled hemorrhoid surgery, or procedure for prolapsing hemorrhoids (PPH), is an excellent alternative for treating internal hemorrhoids that have not been amenable to conservative or nonoperative approaches. […] External hemorrhoid symptoms are generally divided into problems with acute thrombosis and hygiene/skin tag complaints. The former respond well to office excision (not enucleation), whereas operative resection is reserved for the latter.

• #2 Hemorrhoids Treatment & Management: Approach Considerations, Emergency Department Care, Conservative Management

  https://emedicine.medscape.com/article/775407-treatment

  Rubber band ligation is the most-used remedy for grade II and grade III hemorrhoids and is the standard by which other methods are compared. […] Surgical hemorrhoidectomy is the most effective treatment for all hemorrhoids and in particular is indicated in the following situations: Conservative or nonsurgical treatment fails (persistent bleeding or chronic symptoms) […] About 5-10% of people with hemorrhoids eventually require surgical hemorrhoidectomy. […] Nonlaser versus laser hemorrhoidectomy […] Stapled hemorrhoid surgery, or PPH, was first described in 1997-1998 and has become prominent. […] Doppler-guided transanal hemorrhoidal dearterialization (THD Doppler) appears to be a promising procedure in the treatment of hemorrhoids. […] Hemorrhoidal artery ligation (HAL) and rectoanal repair (RAR) (HAL with mucopexy) are other minimally invasive alternatives to conventional hemorrhoidectomy that show promise for prolonged relief in patients with symptomatic hemorrhoidal disease.

• #2 5 common causes of haemorrhoids and treatment options | King Edward VII’s Hospital

  https://www.kingedwardvii.co.uk/health-hub/haemorrhoids-causes-symptoms-treatment-options

  If your haemorrhoids are particularly painful and don’t go away, you may be recommended rubber band ligation or infrafred coagulation therapy. Rubber band ligation involves tying the base of an internal haemorrhoid with a rubber band to cut off blood supply. […] In recent years, great technological advancements have been made to help treat severe cases of haemorrhoids. We can now offer a revolutionary, effective treatment called the Rafaelo procedure. Rafaelo uses well-established radio frequency technology to help shrink internal haemorrhoids. […] One of the huge benefits of Rafaelo is that it is a fifteen-minute walk-in, walk-out day procedure (you can go home after treatment and return to activities the following day). […] Rafaelo also has a high success rate of 90%, which means it can be a one-off treatment with lasting effects.

• #2 Hemorrhoids Treatment & Management: Approach Considerations, Emergency Department Care, Conservative Management

  https://emedicine.medscape.com/article/775407-treatment

  When performed well, operative hemorrhoidectomy should have a 2-5% recurrence rate. Nonoperative techniques, such as rubber band ligation, produce recurrence rates of 30-50% within 5-10 years. […] The major controversies regarding the treatment of hemorrhoids center on the indications for treatment and the choice of operative versus nonoperative therapy. […] Medical management is the initial treatment of choice for grade I internal and nonthrombosed external hemorrhoids. […] Many patients see improvement or complete resolution of their symptoms with conservative measures. Aggressive therapy is reserved for patients who have persistent symptoms after 1 month of conservative therapy. […] Numerous nonoperative methods to destroy internal hemorrhoids are available. Nonsurgical techniques function by rubber band ligation, ablation, sclerosis, or necrosis of mucosal tissues.

• #2 Hemorrhoids: A range of treatments | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/9/612

  Hemorrhoids are a common reason for office visits. Each patient is unique, and with a range of treatments available, treatment can be individualized. This article reviews the diagnosis and decision-making process for individualized treatment. […] Fiber supplements along with dietary and lifestyle changes are recommended for all patients with hemorrhoids regardless of symptom severity. […] Hemorrhoids are graded on a scale of I (least severe) through IV (most severe). Office-based treatments are effective for grades I, II, and some grade III hemorrhoids. Surgical excision is the standard for high-grade hemorrhoids. […] In choosing the treatment for hemorrhoids, one should consider the disease grade and severity, its impact on the quality of life, the degree of pain it causes, the patients likelihood of adhering to treatment, and the patients personal preference.

• #2 Treatment of hemorrhoids: A coloproctologist’s view

  https://www.wjgnet.com/1007-9327/full/v21/i31/9245.htm

  Non-excisional operation for hemorrhoids includes doppler-guided hemorrhoidal artery ligation (DG-HAL) or known as transanal hemorrhoidal dearterialization (THD), and plication of hemorrhoids (or known as ligation anopexy or mucopexy). DG-HAL has been introduced into a surgical practice to cut off the blood supply to hemorrhoids without the need of hemorrhoid removal. […] Stapled hemorrhoidopexy, also known as a procedure for prolapse and hemorrhoids (PPH), is an alternative operation for treating advanced internal hemorrhoids. A circular staple device is used to excise a ring of redundant rectal mucosa just above hemorrhoid bundles – not hemorrhoids per se. […] In conclusion, the better understanding of the pathophysiology of hemorrhoids would prompt the development of effective treatments for hemorrhoids. Preventive measures, by means of dietary and lifestyle modification, may be the best treatment of hemorrhoids. Once hemorrhoids develop, its treatment options mainly depend on the type and severity of hemorrhoids, patients preference and the expertise of physicians. Post-procedural pain and disease recurrence remain the most challenging problems in the treatment of hemorrhoids.

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