History of research of hemorrhoids is a history of one great mistake        

                         History of treatment of hemorrhoids is history of needless invasive treatment.

Gastroenterology May 2004 • Volume 126 • Number 5

American Gastroenterological Association
American Gastroenterological Association medical position statement: Diagnosis and treatment of hemorrhoids

This document presents the official recommendations of the American Gastroenterological Association (AGA) on Hemorrhoids. It was approved by the Clinical Practice Committee on January 8, 2004, and by the AGA Governing Board on February 13, 2004.

Hemorrhoids are a common affliction in the adult population. Symptoms include bleeding, pain, protrusion, and itching. However, because none of these symptoms are specific for hemorrhoids, the diagnosis should only be made after an appropriate physical examination has ruled out other disorders, such as anal fissure, fistula, or abscess.

Internal hemorrhoids are classified according to the symptoms they cause. In the most commonly used classification, first-degree hemorrhoids bleed but do not protrude, second-degree hemorrhoids protrude with defecation but reduce spontaneously, third-degree hemorrhoids protrude and require digital reduction, and fourth-degree hemorrhoids cannot be reduced. External hemorrhoids usually do not cause symptoms unless thrombosis occurs, in which case the patient experiences acute pain.

Treatment of hemorrhoids depends on their severity. Medical therapy is most appropriate for first-degree hemorrhoids. The cornerstone of medical therapy is adequate intake of fiber and water. Topical corticosteroids and analgesics are useful for managing perianal skin irritation due to poor hygiene, mucus discharge, or fecal seepage. Prolonged use of potent corticosteroid prepar