Fast Five Quiz: Hemorrhoid Diagnosis and Treatment

Praveen K. Roy, MD

Disclosures

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.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....