Choice of treatment for haemorrhoids is highly dependent on symptoms

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CLINICAL UPDATE

Choice of treatment for haemorrhoids is highly dependent on symptoms

By Sze-Lin Peng
Patients may delay seeking medical advice for haemorrhoids because of embarrassment
Patients may delay seeking medical advice for haemorrhoids because of embarrassment [Image: derneuemann on Pixabay]

Haemorrhoids are very common in patients presenting to general practice and can significantly impact on quality of life. This article summarises the treatment of haemorrhoids after careful history and accurate examination have been performed

Sze-Lin Peng

This article has been endorsed by the RNZCGP and has been approved for up to 0.25 CME credits for the General Practice Educational Programme and conti, Educate small, BACK panel - grey
References
  1. Song M, Emilsson L, Bozorg SR, et al. Risk of colorectal cancer incidence and mortality after polypectomy: a Swedish record-linkage study. Lancet Gastroenterol Hepatol 2020; 16 March online.
  1. Giacosa A, Frascio F, Munizzi F. Epidemiology of colorectal polyps. Tech Coloproctol 2004;8, Supp.2:243–47.
  1. Alonso-Coello P, Mills E, Heels-Ansdell D, et al. Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Am J Gastroenterol 2006;101(1):181–88.
  1. Gardner IH, Siddharthan RV, Tsikitis VL. Benign anorectal disease: hemorrhoids, fissures, and fistulas. Ann Gastroenterol 2020;33(1):9–18.
  1. Coughlin OP, Wright ME, Thorson AG, et al. Hemorrhoid banding: A cost-effectiveness analysis. Dis Colon Rectum 2019;62(9):1085–94.
  1. Nelson RS, Thorson AG. Risk of bleeding following hemorrhoidal banding in patients on antithrombotic therapy. Gastroenterol Clin Biol 2009;33(6–7):463–65.
  1. Xia W, Manning JPR, Barazanchi AWH, et al. Metronidazole following excisional haemorrhoidectomy: a systematic review and meta-analysis. ANZ J Surg 2018;88(5):408–14.
  1. Ratnasingham K, Uzzaman M, Andreani SM, et al. Meta-analysis of the use of glyceryl trinitrate ointment after haemorrhoidectomy as an analgesic and in promoting wound healing. Int J Surg 2010;8(8):606–11.
  1. Huang YJ, Chen CY, Chen RJ, et al. Topical diltiazem ointment in post-hemorrhoidectomy pain relief: A meta-analysis of randomized controlled trials. Asian J Surg 2018;41(5):431–37.
  1. Brown SR, Tiernan JP, Watson AJM, et al. Haemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree haemorrhoids (HubBLe): a multicentre, open-label, randomised controlled trial. Lancet 2016;388(10042):356–64.