Med. praxi. 2026;23(2):135-139 | DOI: 10.36290/med.2026.015
Hemorrhoidal disease - an overview for clinical practice
- Kolopraktologická poradna, Nemocnice TGM Hodonín
Hemorrhoidal disease is one of the most common benign disorders of the anorectal region and significantly affects patients' quality of life. Although hemorrhoids are a physiological component of the anal canal, pathological changes can lead to symptomatic hemorrhoidal disease. The etiology is multifactorial and includes genetic predisposition, impaired venous outflow, weakening of the connective-tissue support apparatus, and chronic inflammation of the vascular wall. The clinical presentation is variable - from mild anal discomfort to marked bleeding, prolapse, and painful complications. This article provides a comprehensive overview of the anatomy, pathogenesis, clinical manifestations, and classification of hemorrhoidal disease according to Goligher. It further focuses on the diagnostic work-up, including differential diagnosis of anorectal symptoms, with particular emphasis on excluding colorectal carcinoma. Options for conservative, minimally invasive, and surgical treatment are also discussed with regard to the individual stages of the disease. Special attention is paid to complications of hemorrhoidal disease, perianal thrombosis, and specific aspects of management during pregnancy. The aim of the article is to provide a practical and clear resource for primary care physicians - and hopefully also specialists - that facilitates accurate diagnosis, appropriate indication of examinations, and selection of the optimal treatment strategy in patients with hemorrhoidal disease.
Keywords: hemorrhoidal disease, rectal bleeding, Goligher classification, conservative treatment, minimally invasive methods, surgical treatment.
Received: March 2, 2026; Accepted: April 13, 2026; Published: April 28, 2026 Show citation
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