Conservative management is important for patients with hemorrhoids. Decreasing constipation and straining shrinks internal hemorrhoids, thus reducing symptoms. Therefore, retraining toilet habits is an important consideration, and measures to decrease straining and constipation are recommended as part of first-line treatment of all first- and second-degree (and many third- and fourth-degree) internal hemorrhoids.
Nonsurgical techniques, such as infrared coagulation and rubber band ligation, are first-line treatment for first- and second-degree internal hemorrhoids that fail to respond to more conservative therapies, such as dietary changes, toilet retraining, and stool softeners, among others.
Rubber band ligation remains the standard and the most-used remedy for grade II and grade III hemorrhoids that have not responded to conservative treatments.
Surgical interventions, such as excision, are considered aggressive and suggested only when other treatments fail and symptoms are bothersome.
Sclerotherapy can provide adequate treatment of early internal hemorrhoids. However, sclerotherapy and cryotherapy are infrequently used and generally reserved for grade I or II hemorrhoids.
Learn more about hemorrhoid treatment.
This Fast Five Quiz was excerpted and adapted from the Medscape article Hemorrhoids.
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Cite this: B.S. Anand. Fast Five Quiz: Hemorrhoids Practice Essentials - Medscape - Apr 18, 2022.