Skip to main content

Hemorrhoids: Anatomy, Physiology, Concerns, and Treatments

  • Chapter
Anorectal Disease

Abstract

Hemorrhoidal disease is a common condition with a multitude of presenting symptoms and varied treatment options. A careful examination to exclude other more serious conditions is often needed. Treatment options should be tailored based upon each patient’s individual complaint and comorbid medical conditions. A proper understanding of the anorectal anatomy and sound surgical technique will ensure good outcomes with very few complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Eltesmore S, Windsor AC. Surgical history of haemorrhoids. In: Kubchandani I, Paonessa N, Khawaja A, editors. Surgical treatment of hemorrhoids. 2nd ed. London: Springer; 2009. p. 1–4.

    Chapter  Google Scholar 

  2. Sanchez C, Chinn BT. Hemorrhoids. In: Clinics in colon and rectal surgery. New York: Thieme; 2011. 24(1): 5–13

    Google Scholar 

  3. Trion PH. Anatomy and physiology of the anorectum. In: Fazio VW, Church JM, Delaney CP, editors. Current therapy in colon and rectal surgery. 2nd ed. Philadelphia: Elsevier Mosby; 2005. p. 1–4.

    Google Scholar 

  4. Milligan ETC, Morgan CN, Jones LE, Officer R. Surgical anatomy of the anal canal and the operative treatment of haemorrhoids. Lancet 1937 ii. 1119–24

    Google Scholar 

  5. Lee HIT, Spencer RJ, Beart Jr RW. Multiple hemorrhoidal bandings in a single session. Dis Colon Rectum. 1994;37(1):37–41.

    Article  CAS  PubMed  Google Scholar 

  6. Sim AJ, Murie JA, Mackenzie I. Three year follow-up study on the treatment of first and second degree hemorrhoids by sclerosing injection or rubber band ligation. Surg Gynecol Obstet. 1983;157(6):534–6.

    CAS  PubMed  Google Scholar 

  7. Johanson JF, Rimm A. Optimal nonsurgical treatment of hemorrhoids: a comparative analysis of infrared coagulation, rubber band ligation, and injection sclerotherapy. Am J Gastroenterol. 1992;87(11):1600–6.

    CAS  PubMed  Google Scholar 

  8. Milligan ETC, Morgan CN, Jones LE, Officer R. Surgical anatomy of the anal canal and the operative treatment of haemorrhoids. Dis Colon Rectum. 1985;28:620–8.

    Article  Google Scholar 

  9. Khan S, Pawlak SE, Eggenberger JC, et al. Surgical treatment of hemorrhoids: prospective, randomized trial comparing closed excisional hemorrhoidectomy and the Harmonic Scalpel technique of excisional hemorrhoidectomy. Dis Colon Rectum. 2001;44(6):845–9.

    Article  CAS  PubMed  Google Scholar 

  10. Conaghan P, Farouk R. Doppler-guided hemorrhoid artery ligation reduces the need for conventional hemorrhoid surgery in patients who fail rubber hand ligation treatment. Dis Colon Rectum. 2009;52(1):127–30.

    Article  PubMed  Google Scholar 

  11. Maykel, JA. Hemorrhoids. In: Seminars in colon and rectal surgery. Philadelphia: WB Saunders; 2013. 24(2).

    Google Scholar 

  12. Cintron JR, Abcarian H. Benign anorectal: hemorrhoids. In: The ASCRS textbook of colon and rectal surgery. New York: Springer; 2007. p. 156–77.

    Chapter  Google Scholar 

  13. Fleshman J, Madoff R. Hemorrhoids. In: Cameron J, editor. Current surgical therapy. Philadelphia: Elsevier; 2004. p. 245–52.

    Google Scholar 

  14. Wexner SD, Smithy WB, Milsom JW, Dailey TH. The surgical management of anorectal diseases in AIDS and pre-AIDS patients. Dis Colon Rectum. 1986;29(11):719–23.

    Article  CAS  PubMed  Google Scholar 

  15. Chen HEI, Wang JY, Changchien CR, et al. Risk factors associated with post-hemorrhoidectomy secondary hemorrhage: a single institution prospective study of 4880 consecutive closed hemorrhoidectomies. Dis Colon Rectum. 2002;45:1096–9.

    Article  PubMed  Google Scholar 

Suggested Readings

  • Haas PA, Johanson JF, Sonnenberg A. The prevalence of confusion in the definition of hemorrhoids. Dis Colon Rectum. 1992;35(3):290–1.

    Article  CAS  PubMed  Google Scholar 

  • Berenstein WC. What are hemorrhoids and what is their relationship to the portal system? Dis Colon Rectum. 1983;26:829–34.

    Article  Google Scholar 

  • Rato C, Donisi L, Parello A, Litta F, Doglietto GB. Evaluation of transanal hemorrhoidal dearterialization as a minimally invasive therapeutic approach to hemorrhoids. Dis Colon Rectum. 2010;53(5):803–11.

    Article  Google Scholar 

  • Chung YC, Wu HJ. Clinical experience of suture-less closed hemorrhoidectomy with LigaSure. Dis Colon Rectum. 2003;46(1):87–92.

    Article  PubMed  Google Scholar 

  • Shafik A. Surgical anatomy of hemorrhoids. In: Kubchandani I, Paonessa N, Khawaja A, editors. Surgical treatment of hemorrhoids. 2nd ed. London: Springer; 2009. p. 7–13.

    Chapter  Google Scholar 

  • Aigner F, Gruber H, Conrad F, et al. Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease. Int J Colorectal Dis. 2009;24(1):105–13.

    Article  PubMed  Google Scholar 

  • Bayer I, Myslovaty B, Picovsky BM. Rubber band ligation of hemorrhoids. Convenient and economic treatment. J Clin Gastroenterol. 1996;23(1):50–2.

    Article  CAS  PubMed  Google Scholar 

  • MacRae ITM, McLeod RS. Comparison of hemorrhoidal treatments: a meta-analysis. Can J Surg. 1997;40(1):14–7.

    PubMed Central  CAS  PubMed  Google Scholar 

  • Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buis JG. Symptomatic hemorrhoids: current incidence and complications of operative therapy. Dis Colon Rectum. 1992;35(5):477–81.

    Article  CAS  PubMed  Google Scholar 

  • Sneider EB, Maykel JA. Diagnosis and management of symptomatic hemorrhoids. Surg Clin North Am. 2010;90(1):17–32.

    Article  PubMed  Google Scholar 

  • Dietrich III CS, Hill CC, Hueman M. Surgical diseases presenting in pregnancy. Surg Clin North Am. 2008;88(2):403–19. vii-viii.

    Article  PubMed  Google Scholar 

  • Hoff SD, Bailey HR, Butts DR, et al. Ambulatory surgical hemorrhoidectomy--a solution to postoperative urinary retention? Dis Colon Rectum. 1994;37(12):1242–4.

    Article  CAS  PubMed  Google Scholar 

  • Beck D. Hemorrhoidal disease. In: Beck DE, Wexner SD, editors. Fundamentals of anorectal surgery. Philadelphia: WB Saunders; 2001. p. 236–52.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael Page MD, FACS, FASCRS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Coughlin, O., Page, M. (2016). Hemorrhoids: Anatomy, Physiology, Concerns, and Treatments. In: Zutshi, M. (eds) Anorectal Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-23147-1_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-23147-1_10

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23146-4

  • Online ISBN: 978-3-319-23147-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics