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Hemorrhoidal Disease: A Comprehensive Review of Pathophysiology, Classification, and Evidence-Based Management

Abstract:
Hemorrhoidal disease (HD) is a highly prevalent anorectal condition, affecting over 10 million individuals in the United States and with a global prevalence of 4.4% to 39%, leading to significant morbidity through symptoms such as bleeding, prolapse, pain, pruritus, and irritation that impair quality of life. Recent real-world evidence and meta analyses highlight the role of conservative and minimally invasive treatments in reshaping management strategies, reducing recurrence, and enhancing patient outcomes.