Hemorrhoids

Rectal bleeding is a characteristic feature of symptomatic hemorrhoids, which should also be monitored. Patients with continuous bleeding or those who develop symptomatic anemia require early endoscopic evaluation (colonoscopy) to eliminate other proximal pathology prior to interventional treatment for hemorrhoids.​[2]Gallo G, Martellucci J, Sturiale A, et al. Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease. Tech Coloproctol. 2020 Feb;24(2):145-64. https://link.springer.com/article/10.1007/s10151-020-02149-1 http://www.ncbi.nlm.nih.gov/pubmed/31993837?tool=bestpractice.com [13]Hawkins AT, Davis BR, Bhama AR, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of hemorrhoids. Dis Colon Rectum. 2024 May 1;67(5):614-23. https://journals.lww.com/dcrjournal/fulltext/2024/05000/the_american_society_of_colon_and_rectal_surgeons.5.aspx ​​ Typically, patients are reviewed to confirm wound healing and symptom resolution following treatment. Long-term follow-up is unnecessary unless there are any treatment-related complications or recurrence of persistent symptoms, especially sinister gastrointestinal symptoms (e.g., bleeding, anemia, alteration in bowel habits, abdominal pain, weight loss) in which case patients require re-evaluation including colonoscopy.