Hemorrhoids

Hemorrhoids are a common and misunderstood condition seen by medical practi tioners worldwide. Correct appreciation of the anatomy and physiology helps the physician to approach their management in a scientific manner. Numerou s nonoperative techniques are available, all with similar efficacies. Surgi cal excision is the gold standard treatment for the small group of hemorrho ids that fail nonoperative treatment. Certain subgroups of patients, such a s those who have Crohn's disease, are pregnant, or are acute, present diffi cult management issues to the physician. New techniques and better pain rel ief will hopefully lead to day-stay surgery, reduced complication, and bett er patient satisfaction in the future.