Fast Five Quiz: Hemorrhoid Diagnosis and Treatment

Praveen K. Roy, MD


March 07, 2019

The American College of Gastroenterology guidelines include the following recommendations:

  • Most patients who present urgently (within 3 days of onset) with a thrombosed external hemorrhoid benefit from excision.

  • Providers should treat patients with symptomatic hemorrhoids first with increased fiber intake and adequate fluids.

  • Providers should consider patients with first-degree to third-degree hemorrhoids that remain symptomatic after dietary modifications for such procedures as banding, sclerotherapy, and infrared coagulation. Ligation is probably the most effective option.

  • Providers should refer for surgical operations (hemorrhoidectomy, stapled hemorrhoidopexy, and Doppler-assisted hemorrhoidal artery ligation) those patients who are refractory to or who cannot tolerate office procedures; those who have large symptomatic, external tags along with their hemorrhoids; those who have large third-degree hemorrhoids; or those who have fourth-degree hemorrhoids.

Read more on the treatment of hemorrhoids.


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