Published online Aug 21, 2015. doi: 10.3748/wjg.v21.i31.9245
Peer-review started: January 27, 2015
First decision: April 14, 2015
Revised: April 21, 2015
Accepted: July 3, 2015
Article in press: July 3, 2015
Published online: August 21, 2015
Core tip: Hemorrhoids is a very common anorectal disease defined as the symptomatic enlargement and/or distal displacement of anal cushions. Apart from abnormally dilated vascular channel and destructive changes in supporting tissue within anal cushions, there is emerging evidence that hemorrhoids is associated with hyperperfusion state of anorectal region and some degree of tissue inflammation. This article comprehensively and thoroughly reviews the pathophysiology, clinical diagnosis, and current treatment of hemorrhoids - which includes dietary and lifestyle modification, pharmacological approach, office-based procedures and operations for hemorrhoids (such as hemorrhoidectomy and other non-excisional surgery). The management of hemorrhoids in complicated situations is also addressed.