Curbside Consultation of the Colon: 49 Clinical Questions

Brooks D. Cash, MD, FACP, CDR, MC, USN

Question 34: What Types Of Procedures And Therapies Can I Use On Hemorrhoids Before Sending A Patient To The Surgeon? (continued)

Brian E. Lacy, MD, PhD

Although common, hemorrhoids are widely misunderstood by both patients and physicians. They are mistakenly blamed for a variety of perianal symptoms and are frequently confused with other perianal disorders. A thorough understanding of the pathophysiology of hemorrhoids is essential if appropriate treatment is to be provided. Hemorrhoids have a prevalence rate of approximately 4%, affect men and women equally, and increase in incidence with age.1 The natural history of hemorrhoids has not been well studied. A cushion of tissue lies beneath the mucosa of the anal canal. This cushion, supported…