Hemorrhoids are vascular structures of the anal canal in each individual plays an important role in fecal continence. In the presence of symptoms such as bleeding, pain, itching, there may be a pathological condition called hemorrhoidal disease.
In Western countries at various stages of hemorrhoidal disease affects more than 50% of the population and is thus an extremely common disease.
There are several classifications of hemorrhoids, more or less recent, but the distinction of internal and external to the subdivision into four grades, while not the last created are still the most widely used in clinical practice.
If there are symptoms, the first thing to do ‘a visit that may be performed usually by the attending physician, the specialist surgeon or a Coloproctology: It’ important to put a correct diagnosis and differentiate other benign or malignant anorectal region or colon which may present with similar symptoms.
Once confirmed the diagnosis and defined the stage of disease and the symptoms may consider treatment options.
Most of the patients permanently or temporarily solves the problem with medical therapy, or regularization of the hive, dietary modifications and use of customized local or systemic therapies that address the symptomatic picture. In case of continuation or recurrence of symptoms, however, and ‘possible to consider other therapeutic options.


Band ligation and an outpatient procedure, painless, performed without anesthesia, repeatable, and saddled with a low number of complications that solves the paintings less advanced disease and may be used in patients with contraindications to surgical therapy. The results are excellent and, in case of relapse or worsening of the picture, you can perform a surgical procedure when indicated.
Sclerotherapy has indications and similar results and is practiced with equal success.
Surgical therapy now relies substantially dell’emorroidectomia performed according to traditional techniques and then defined open or closed second Morgan Ferguson.
In some cases it is practiced with the use of surgical instruments recently introduced in clinical practice, such as radio frequency or ultrasound.
This is an effective surgical procedure whose validity is documented by decades of experience, requiring anesthesia (usually general or locoregional, more rarely local), usually a day of hospitalization and which, like all surgeries, complications (especially the bleeding and stenosis) and a number, modest, failures or relapses.


Recently ‘introduced a new technique, called mucoprolassectomia with stapler second long, which is based on different pathophysiological conditions and has found great application around the world.Omega’ further development of this technique led to the ‘intervention of so-called STARR (Transanal Stapler rectal resection) that allows resection more ‘radical prolapse Then we go and properly treated degrees of illness more’ advanced.
Also here is a real surgical procedure requiring general or locoregional anesthesia, usually a day of hospitalization, complications, and a number of failures or relapses.
In most cases, however, these techniques are effective, painless and settle the hemorrhoidal disease if performed correctly and with the right guidance.
A new technique, called ligation doppler guided hemorrhoidal artery, and then HAL is still awaiting confirmation in terms of effectiveness before they find application on a large scale even if the preliminary results appear to have lower efficacy in advanced disease where the degree of prolapse is a significant component of.

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