[Pathogenesis, clinical aspects and conservative therapy of hemorrhoids].

Hemorrhoids are readily diagnosed by proctoscopy. They should not be treated without thorough examination, as carcinoma of the rectum or sigmoid may cause similar symptoms. The examination should include careful inspection of the anal region, digital palpation, proctoscopy and sigmoidoscopy. Once the diagnosis is established, instruction in anal hygiene should first be given. Local use of ointment and suppositories follows. If this symptomatic treatment fails, sclerosing injections are recommended. For this purpose various irritant solutions are used which may on occasion lead to complications such as local and, in rare cases, extensive necrosis of the rectal mucosa. In the search for a method which avoids any type of irritant substance, coagulation by infrared radiation using a special probe has been developed and found to be at least as successful as injection treatment. For prolapsing piles, however, rubber band ligature appears to be the most effective method.