Symposium on outpatient anorectal procedures. Alternatives to surgical hemorrhoidectomy.

Hemorrhoids are an extremely common affliction. The prevalence ranges from 1 in 25 to 1 in 30 individuals. There was a 20% decrease in the number of hemorrhoidectomies performed between 1978 and 1982. Alternatives to formal hemorrhoidectomy are injection sclerotherapy and rubber-band ligation. High-fibre diets and bulk laxatives are effective in relieving the symptoms of hemorrhoids, easing defecation and regulating bowel habit and can be used liberally. Bleeding hemorrhoids can be treated by diet alone, or by injection or rubber-band ligation. Prolapsing hemorrhoids are best treated by rubber-band ligation. The relatively few patients in whom these more conservative measures fail can be considered for hemorrhoidectomy.