Management of haemorrhoids

doi:10.1136/bmj.39465.674745.80

BMJ 2008;336:380-383 (16 February), doi:10.1136/bmj.39465.674745.80

Clinical Review

Management of haemorrhoids

Austin G Acheson, associate professor of surgery, John H Scholefield, professor of surgery

¹ Section of Gastrointestinal Surgery, University Hospital, Queen’s Medical Centre, Nottingham NG7 2UH

Correspondence to: A G Acheson austin.acheson@nottingham.ac.uk

The first 150 words of the full text of this article appear below.

Haemorrhoids or "piles" are enlarged vascular cushions withinthe anal canal that have been described for many centuries andcontinue to form a large part of a colorectal surgeon’sworkload. The exact incidence of this common condition is difficultto estimate as many people are reluctant to seek medical advicefor various personal, cultural, and socioeconomic reasons, butepidemiological studies report a prevalence varying from 4.4%in adults in the United States to over 30% in general practicein London.¹ ² The treatment of haemorrhoids is still evolving,and this article provides an update on the role of establishedand innovative treatments (fig 1).

View larger version (71K):

Fig 1 Suggested algorithm for management of haemorrhoids (dotted arrows indicate failure of initial treatment)

Articles were retrieved from the Medline database and Cochranelibrary under the MeSH subheadings "hemorrhoid" and "haemorrhoid".We included randomised controlled trials and meta-analyses.

Haemorrhoids are enlarged vascular cushionsin the . . . [Full text of this article]

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