Office-Based Management of Hemorrhoids

The office-based management of hemorrhoids is an important component of many colorectal surgical practices. This article reviews current data regarding the evaluation of hemorrhoidal symptoms, evidence for medical therapies for hemorrhoidal symptoms with a discussion of flavonoids, evidence for nonoperative treatment of hemorrhoids, and a discussion of treatment of thrombosed external hemorrhoids. In addition, evidence surrounding novel therapies including Doppler-guided hemorrhoidal artery ligation and radiofrequency ablation is discussed.