Hemorrhoidal disease impacts 10 million Americans, causing bleeding, pain, and discomfort. First-line treatments like increased fiber and water intake, along with phlebotonics, often fail, leading to 80% symptom recurrence. Office-based interventions are vital for grades I to III; rubber band ligation offers 89% short-term relief, but may require repeat procedures. Excisional hemorrhoidectomy achieves low recurrence rates but entails longer recovery. Outpatient treatment for thrombosed external hemorrhoids within 72 hours significantly reduces pain and re-thrombosis risk.
Journal Article by Ashburn JH in JAMA