Hemorrhoids pp 113-118 | Cite as

Management of Hemorrhoidal Disease in Special Conditions

  • I. Ethem GecimEmail author
Reference work entry
Part of the Coloproctology book series (COLOPROCT, volume 2)


In this chapter, management of hemorrhoidal disease in special conditions is discussed. These special conditions include acutely thrombosed or strangulated external hemorrhoids and hemorrhoidal disease in pregnancy, in patients with cirrhosis or portal hypertension, in patients having anticoagulant or antiplatelet drugs, and in patients with immune deficiency. Medical and surgical treatments, alternatives of treatment, complications, and outcome are presented.


  1. Abramowitz L, Batallan A (2003) Epidemiology of anal lesions (fissure and thrombosed external hemorroid) during pregnancy and post-partum. Gynecol Obstet Fertil 31(6):546–549CrossRefPubMedGoogle Scholar
  2. Chan KK, Arthur JD (2013) External haemorrhoidal thrombosis: evidence for current management. Tech Coloproctol 17(1):21–25CrossRefPubMedGoogle Scholar
  3. Gorfine SR (1995) Treatment of benign anal disease with topical nitroglycerin. Dis Colon Rectum 38(5):453–456. discussion 456–7CrossRefPubMedGoogle Scholar
  4. Greenspon J, Williams SB, Young HA, Orkin BA (2004) Thrombosed external hemorrhoids: outcome after conservative or surgical management. Dis Colon Rectum 47:1493–1498CrossRefPubMedGoogle Scholar
  5. Hewitt WR, Sokol TP, Fleshner PR (1996) Should HIV statusalter indications for hemorrhoidectomy? Dis Colon Rectum 39:615–618CrossRefPubMedGoogle Scholar
  6. Hosking SW, Johnson AG, Smart HL, Triger DR (1989) Anorectal varices, haemorrhoids and portal hypertension. Lancet 333(8634):349–352CrossRefGoogle Scholar
  7. Juusola JL, Brandeau ML (2016) HIV treatment and prevention a simple model to determine optimal investment. Med Decis Mak 36(3):391–409CrossRefGoogle Scholar
  8. Lohsiriwat V (2013) Approach to hemorrhoids. Curr Gastroenterol Rep 15:332CrossRefPubMedGoogle Scholar
  9. Lohsiriwat V (2015) Treatment of hemorrhoids: a coloproctologist’s view. World J Gastroenterol 21(31):9245–9252CrossRefPubMedPubMedCentralGoogle Scholar
  10. Mirhaidari SJ, Porter JA, Slezak FA (2016) Thrombosed external hemorrhoids in pregnancy: a retrospective review of outcomes. Int J Color Dis 31:1557CrossRefGoogle Scholar
  11. Moesgaard F, Nielsen ML, Hansen JB, Knudsen JT (1982) High-fiber diet reduces bleeding and pain in patients with hemorrhoids: a double-blind trial of Vi-Siblin. Dis Colon Rectum 25(5):454–456CrossRefPubMedGoogle Scholar
  12. Morandi E, Merlini D, Salvaggio A, Foschi D, Trabucchi E (1999) Prospective study of healing time after hemorrhoidectomy: influence of HIV infection, acquired immunodeficiency syndrome, and anal wound infection. Dis Colon Rectum 42(9):1140–1144CrossRefPubMedGoogle Scholar
  13. Mounsey AL, Halladay J, Sadiq TS (2011) Hemorrhoids. Am Fam Physician 84:204–210PubMedGoogle Scholar
  14. Nadal SR, Manzione CR, Galvão VM, Salim VR, Speranzini MB (1999) Perianal diseases in HIV-positive patients compared with a seronegative population. Dis Colon Rectum 42(5):649–654CrossRefPubMedGoogle Scholar
  15. Oh HK, Moon SH, Ryoo S, Choe EK, Park KJ (2014) Results of surgical treatment on benign anal diseases in Korean HIV-positive patients. J Korean Med Sci 29(9):1260–1265CrossRefPubMedPubMedCentralGoogle Scholar
  16. Ono T, Goto K, Takagi S, Iwasaki S, Komatsu H (2005) Sclerosing effect of OC-108, a novel agent for hemorrhoids, is associated with granulomatous inflammation induced by aluminum. J Pharmacol Sci 99:353–363CrossRefPubMedGoogle Scholar
  17. Patti R, Arcara M, Bonventre S, Sammartano S, Sparacello M, Vitello G, Di Vita G (2008 Nov) Randomized clinical trial of botulinum toxin injection for pain relief in patients with thrombosedexternal haemorrhoids. Br J Surg 95(11):1339–1343CrossRefPubMedGoogle Scholar
  18. Perera N, Liolitsa D, Iype S, Croxford A, Yassin M, Lang P, Ukaegbu O, van Issum C (2012) Phlebotonics for haemorrhoids. Cochrane Database Syst Rev 15(8):CD004322. doi: 10.1002/14651858.CD004322.pub3Google Scholar
  19. Perrotti P, Antropoli C, Molino D, De Stefano G, Antropoli M (2001) Conservative treatment of acute thrombosed external hemorrhoids with topical nifedipine. Dis Colon Rectum 44(3):405–409CrossRefPubMedGoogle Scholar
  20. Rivadeneira DE, Steele SR, Ternent C, Chalasani S, Buie WD, Rafferty JL (2011) Practice parameters for the management of hemorrhoids (revised 2010). Dis Colon Rectum 54(9):1059–1064CrossRefPubMedGoogle Scholar
  21. Ruiz-Moreno F (1970) Surgery in the puerperium for painful anorectal disorders. Proc R Soc Med 63(Suppl 1):102–103PubMedPubMedCentralGoogle Scholar
  22. Shi Z, Zhou J, He X (1981) On treatment of third degree internal hemorrhoids with “Xiaozhiling” injection. J Tradit Chin Med 1:115–120Google Scholar
  23. Song SG, Kim SH (2011) Optimal treatment of symptomatic hemorrhoids. J Korean Soc Coloproctol 27(6):277–281CrossRefPubMedPubMedCentralGoogle Scholar
  24. Wolkomir AF, Barone JE, Hardy HW, Cottone FJ (1990) Abdominal and anorectat surgery and the acquired immune deficiency syndrome in heterosexual intravenous drug users. Dis Colon Rectum 33:267–270CrossRefPubMedGoogle Scholar
  25. Wong JCH, Chung CC, Yau KK, Cheung HYS, Wong DCT, Chan OCY, Li MKW (2008) Stapled technique for acute thrombosed hemorrhoids: a randomized, controlled trial with long-term results. Dis Colon Rectum 51:397–403CrossRefPubMedGoogle Scholar
  26. Zuber TJ (2002) Punch biopsy of the skin. Am Fam Physician 65(8):1629–1632PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Ankara University Medical SchoolAnkaraTurkey

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