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المستخلص
Haemorrhoidal disease is one of the most common anorectal conditions. Haemorrhoids consist of vascular cushions that are involved in the maintenance of continence and discrimination between flatus and faeces. The terminal branches of the superior rectal artery is the main blood supply of the haemorrhoidal plexus .
It is now widely accepted that haemorrhoids result from downward displacement of the anal cushions caused by fragmentation of the submucosal smooth muscle and connective tissue fibres (which anchor the anal cushions to the underlying internal sphincter and conjoint longitudinal muscle) as a result of prolonged straining during defaecation.
Currently treatment of haemorrhoids is divided into non-operative and operative approaches. Non-operative approaches include conservative management and out-patient (office) treatment. Operative approaches include excisional haemorrhoidectomy and non-excisional techniques which include stapled haemorrhoidopexy and Doppler - guided haemorrhoidal artery ligation. Safety is of paramount importance, especially when treating a benign disease such as haemorrhoids. Furthermore, complications and subsequent disability are important factors on which patients often decide whether or not to accept any treatment despite troublesome symptoms.