Conservative treatment of hemorrhoids

Hemorrhoidal tissues are derived from anal vascular cushions, which contain arterio-venous channels. These cushions are involved in fine tuning continence. Prolonged and repeated straining results in engorgement and prolapse of these cushions. As hemorrhoids have an important function in fine tuning continence, one should first use non-operative methods of treatment if hemorrhoids are minimally prolapsing. Correction of toilet habits is an important first step in management. Rubber band ligation is superior to injection sclerotherapy. Infrared photocoagulation and cryotherapy are of limited use. Hemorrhoidal artery ligation shows promise.