Hemorrhoidal disease

Abstract

Hemorrhoids, or piles, have been recognized and treated since antiquity. This condition represents the most frequently presenting anal disease, 50-90% of people experiencing them at least once in their lives. Although most patients present with symptoms, many do not and some never have complaints. The incidence of hemorrhoids seems to increase with age, but the disease is by no means confined to older individuals, being encountered in patients of all ages, even in childhood [1, 2]. Men seem to be affected twice as frequently as women. The peak prevalence for both genders occurs between 45 and 65 years of age. The occidental lifestyle predisposes us to piles. Patients suffering from the condition belong to a heterogeneous group and 5-10% will need surgical treatment to resolve their problem. The cardinal features of hemorrhoids are bleeding, anal pruritus, prolapse, and pain due to thrombosis. Although the symptoms may strongly suggest a diagnosis of hemorrhoids, confirmation by anoscopy, flexible sigmoidoscopy, or colonoscopy should be performed systematically if bleeding is present. © 2010 Springer-Verlag Berlin Heidelberg.