Guttenplan Mitchel
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Curr Gastroenterol Rep. 2017 Jul;19(7):30. doi: 10.1007/s11894-017-0574-9.
Hemorrhoid disease is extremely common, and seldom requires surgical intervention. The vast majority of patients can be cared for in the office setting and by the gastroenterologist. This piece aims to summarize the epidemiology and pathophysiology of hemorrhoid disease, along with the proper evaluation and office-based treatment of these patients.
Most GI fellowship training programs spend little time on these topics, and the recommendation has been made to include anorectal care in the GI's "core curriculum." The use of the anoscope and a proper anorectal examination are keys to evaluating these patients, and the techniques available to treat these patients are described. Often overlooked in these patients are other anorectal issues that occur alongside hemorrhoidal issues very commonly-the most common being anal fissure. Comprehensive management of all of these issues will allow all but the most severely affected patients to avoid the expense and morbidity of surgical intervention. The anatomy, etiology, pathophysiology, diagnosis, and non-surgical treatment of hemorrhoid disease are presented with the gastroenterologist in mind.
痔病极为常见，很少需要手术干预。绝大多数患者可在门诊由胃肠病学家进行诊治。本文旨在总结痔病的流行病学和病理生理学，以及对这些患者的正确评估和门诊治疗。
大多数胃肠病学 fellowship 培训项目在这些主题上花费的时间很少，有人建议将肛肠护理纳入胃肠病学的“核心课程”。使用肛门镜和进行适当的肛肠检查是评估这些患者的关键，并描述了可用于治疗这些患者的技术。在这些患者中，其他与痔病同时非常常见的肛肠问题常常被忽视——最常见的是肛裂。对所有这些问题进行综合管理将使除病情最严重的患者外的所有患者避免手术干预的费用和并发症。本文在考虑胃肠病学家的情况下介绍了痔病的解剖学、病因学、病理生理学、诊断和非手术治疗。
