Hemorrhoids: From basic pathophysiology to clinical management

This review discusses the pathophysiology, epidemiology, risk factors, classification, clinical evaluation, and current non-operative and operative treatment of hemorrhoids. Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions. The most common sy...

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Main Author: Varut Lohsiriwat
Other Authors: Mahidol University
Format: Review
Published: 2018
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/14807
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spelling th-mahidol.148072018-06-11T12:11:19Z Hemorrhoids: From basic pathophysiology to clinical management Varut Lohsiriwat Mahidol University Medicine This review discusses the pathophysiology, epidemiology, risk factors, classification, clinical evaluation, and current non-operative and operative treatment of hemorrhoids. Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions. The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement. The abnormal dilatation and distortion of the vascular channel, together with destructive changes in the supporting connective tissue within the anal cushion, is a paramount finding of hemorrhoids. It appears that the dysregulation of the vascular tone and vascular hyperplasia might play an important role in hemorrhoidal development, and could be a potential target for medical treatment. In most instances, hemorrhoids are treated conservatively, using many methods such as lifestyle modification, fiber supplement, suppositorydelivered anti-inflammatory drugs, and administration of venotonic drugs. Non-operative approaches include sclerotherapy and, preferably, rubber band ligation. An operation is indicated when non-operative approaches have failed or complications have occurred. Several surgical approaches for treating hemorrhoids have been introduced including hemorrhoidectomy and stapled hemorrhoidopexy, but postoperative pain is invariable. Some of the surgical treatments potentially cause appreciable morbidity such as anal stricture and incontinence. The applications and outcomes of each treatment are thoroughly discussed. © 2012 Baishideng. All rights reserved. 2018-06-11T05:11:19Z 2018-06-11T05:11:19Z 2012-05-07 Review World Journal of Gastroenterology. Vol.18, No.17 (2012), 2009-2017 10.3748/wjg.v18.i17.2009 10079327 2-s2.0-84860545758 https://repository.li.mahidol.ac.th/handle/123456789/14807 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84860545758&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Varut Lohsiriwat
Hemorrhoids: From basic pathophysiology to clinical management
description This review discusses the pathophysiology, epidemiology, risk factors, classification, clinical evaluation, and current non-operative and operative treatment of hemorrhoids. Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions. The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement. The abnormal dilatation and distortion of the vascular channel, together with destructive changes in the supporting connective tissue within the anal cushion, is a paramount finding of hemorrhoids. It appears that the dysregulation of the vascular tone and vascular hyperplasia might play an important role in hemorrhoidal development, and could be a potential target for medical treatment. In most instances, hemorrhoids are treated conservatively, using many methods such as lifestyle modification, fiber supplement, suppositorydelivered anti-inflammatory drugs, and administration of venotonic drugs. Non-operative approaches include sclerotherapy and, preferably, rubber band ligation. An operation is indicated when non-operative approaches have failed or complications have occurred. Several surgical approaches for treating hemorrhoids have been introduced including hemorrhoidectomy and stapled hemorrhoidopexy, but postoperative pain is invariable. Some of the surgical treatments potentially cause appreciable morbidity such as anal stricture and incontinence. The applications and outcomes of each treatment are thoroughly discussed. © 2012 Baishideng. All rights reserved.
author2 Mahidol University
author_facet Mahidol University
Varut Lohsiriwat
format Review
author Varut Lohsiriwat
author_sort Varut Lohsiriwat
title Hemorrhoids: From basic pathophysiology to clinical management
title_short Hemorrhoids: From basic pathophysiology to clinical management
title_full Hemorrhoids: From basic pathophysiology to clinical management
title_fullStr Hemorrhoids: From basic pathophysiology to clinical management
title_full_unstemmed Hemorrhoids: From basic pathophysiology to clinical management
title_sort hemorrhoids: from basic pathophysiology to clinical management
publishDate 2018
url https://repository.li.mahidol.ac.th/handle/123456789/14807
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