Jennifer S. Davids, Timothy J. Ridolfi

Key Concepts

  • Hemorrhoids represent a sizeable source of patient morbidity, with a broad array of associated symptoms.
  • Knowledge of anorectal and hemorrhoid anatomy is critical to selecting the appropriate treatment.
  • Minimizing straining, improving hydration, and increasing fiber intake are the first step for patients with symptomatic hemorrhoids.
  • Most office procedures are best suited for symptomatic grade I–III internal hemorrhoids or thrombosed external hemorrhoids.
  • One’s armamentarium should include a variety of techniques for symptomatic hemorrhoids to optimize outcomes and provide individualized therapy.
  • Complications of hemorrhoid surgery include urinary retention, bleeding, infection, stenosis, incontinence, and recurrence.
  • Special considerations include pregnant patients, as well as those with Crohn’s disease, immunocompromise, or portal hypertension.

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Last updated: January 26, 2022