Hemorrhoids and anal fissures. Common problems, current solutions.

Recent insights into the nature of hemorrhoids and anal fissures have led to specific strategies for treatment. Symptomatic hemorrhoids often result from prolapse of submucosal vascular cushions. Appropriate treatments include dietary change, injection therapy, rubber-band ligation, and hemorrhoidectomy. Patients with anal fissures usually have an abnormal contraction of the sphincter. Many fissures heal spontaneously. Treatment often centers on helping the patient avoid constipation, although surgery is indicated in some cases.