Alternatives in the Treatment of Hemorrhoidal Disease*

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Abstract
Pain, bleeding, protrusion, soilage, itching, and burning are anorectal complaints associated with hemorrhoidal disease. Although hemorrhoidectomy remains the treatment of choice for grade 3 and 4 hemorrhoids, symptoms can be controlled short of hemorrhoidectomy, the alternative methods being effective in lesser degrees of involvement, such as grades 1, 2, and 3. Cryosurgery and dilatation are fading alternatives; laser is becoming more widely used, but results have not been fully evaluated. Sclerotherapy, rubber band ligation, and infrared coagulation are also effective alternatives for patients who demand nonsurgical therapy.