REVIEW   

Chirurgia 2021 August;34(4):166-8

DOI: 10.23736/S0394-9508.20.05235-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Conservative treatment of hemorrhoids

Giovanni CESTARO ✉, Fabio CAVALLO, Monica ZESE, Daniela PRANDO, Ferdinando AGRESTA

Unit of General Surgery, S. Maria Regina degli Angeli Hospital, ULSS5 Polesana, Adria, Rovigo, Italy

Hemorrhoids consist of vascular tissue, with many arterial-venous anastomoses supported by a tissue structure made of various elastic fibers and collagen. The most important function of these hemorrhoidal “pillows” is to be a part of an adequate continence function. Hemorrhoidal disease is a frequent condition that affects many adult patients. We did literature research on PUBMED using the following terms: “hemorrhoids” and “conservative treatment” and “HeLP.” Our design was to realize a synthetic narrative review about conservative treatment of hemorrhoidal disease. We can consider the conservative treatment a valid option for I - II and III grade hemorrhoids. It consists of dietary complements and various outpatient procedure. Among these, sclerotherapy, rubber band ligation and laser treatment represent the most useful and tested techniques. Hemorrhoidal Laser Procedure (HeLP) is the most expensive treatment in an outpatient setting. Supplements are usually prescribed too: diosmin, hesperidin, troxerutin and escin showed better long-term results. Moreover, cortisone suppositories have limited efficacy. In a procto-setting, an accurate evaluation of hemorrhoidal disease grading and related symptoms is a valuable background to obtain a “tailored” treatment of this pathological condition.

KEY WORDS: Hemorrhoids; Conservative treatment; Sclerotherapy