Measuring Symptom Severity and Health-Related Quality-of-Life with Hemorrhoid Treatments: Systematic Review.

BACKGROUND

Hemorrhoids are common and relief anchors on symptom improvement. Despite several available treatment options, the optimal patient-reported outcome measure for contemporary clinical trials is not established.

OBJECTIVE

We aimed to systematically assess patient-reported outcome measures that measure hemorrhoid symptom severity and/or health-related quality of life.

DATA SOURCES: A systematic review was performed using PubMed and Embase (1980-2025).

STUDY SELECTION: Prospective development/validation studies evaluating patient-reported outcome measures relevant to hemorrhoidal disease.

MAIN OUTCOME MEASURES: Patient-reported outcome measures were evaluated on key measurement properties of reliability, internal consistency, construct validity, and responsiveness according to COSMIN v2.0 criteria.

RESULTS

Of the 1,266 total studies reviewed, nine patient-reported outcome measures were identified: seven measure symptom severity and six measure health-related quality-of-life. Three demonstrated reliability, internal consistency, construct validity, and responsiveness. The Patient Reported Outcome Measure-Haemorrhoidal Impact And Satisfaction Score comprehensively measures symptom severity, health-related quality-of-life, and treatment satisfaction. The Hemorrhoidal Disease Symptom Score classifies patients with high or low symptom load, and when used in combination with Short Health Scale-Hemorrhoidal Disease, also measures impact on health-related quality of life.

LIMITATIONS: Preference toward specific measures may differ between clinical trials and clinical practice.

CONCLUSIONS

We identify two viable patient-reported outcome measures for use in future clinical trials that evaluate hemorrhoid interventions.