From the Research
The treatment of hemorrhoids, also known as haimoritis, should prioritize medical management, including stool softeners, topical over-the-counter preparations, and dietary modifications, as the initial therapy, as recommended by the American Family Physician in 2018 1.
Initial Treatment
The initial treatment of hemorrhoids should focus on medical management, which includes:
- Stool softeners to reduce straining during bowel movements
- Topical over-the-counter preparations to relieve pain and discomfort
- Dietary modifications, such as increased fiber and water intake, to prevent constipation
Office-Based Treatment
If medical management is unsuccessful, office-based treatment with rubber band ligation is the preferred next step for grades I to III internal hemorrhoids, as it has a lower failure rate than infrared photocoagulation 1.
Surgical Treatment
Surgical treatment, such as open or closed hemorrhoidectomy, is reserved for recurrent or higher-grade disease, as it leads to greater surgical success rates but also incurs more pain and a prolonged recovery than office-based procedures 1.
Lifestyle Modifications
Lifestyle modifications, such as increasing daily fiber intake to more than 12g and daily water intake to more than 2L, can help reduce the risk of internal hemorrhoidal disease, as found in a case-control study published in La Tunisie medicale in 2019 2.
New Treatment Options
New treatment options, such as sublingual nanoemulsion and liquid bandage, have been reported to be effective and safe in the management of hemorrhoidal disease, as discussed in the European review for medical and pharmacological sciences in 2020 3.