AGA Clinical Practice Update Provided for Diagnosis, Treatment of Hemorrhoids

THURSDAY, April 30, 2026 (HealthDay News) -- Dietary and lifestyle modifications are reasonable first-line therapies for symptomatic hemorrhoids, according to a clinical practice update issued by the American Gastroenterological Association and published online April 29 in Gastroenterology.Waqar Qureshi, M.D., from the Baylor College of Medicine in Houston, and colleagues commissioned and approved an expert review to provide guidance on diagnosis and treatment of hemorrhoid disease.The authors developed 11 Best Practice Advice statements, indicating that hemorrhoid diagnosis and treatment are within the purview of gastroenterologists; by taking a history from and examining the patient, diagnosis and grading of hemorrhoids is easily made. Symptoms include bleeding, itching, discomfort, and/or prolapse. Reasonable first-line therapies for symptomatic hemorrhoids include dietary and lifestyle modifications, including increasing fiber intake and avoiding straining or prolonged time on the toilet. Limited scientific data are available for use of sitz baths for symptom improvement, although they are often advised. Topical treatments can be considered for treatment of symptomatic hemorrhoids, but the data supporting efficacy are limited. Topical steroids should not be used for more than two weeks. To ensure accurate diagnosis, anoscopy should be performed on every new patient with suspected hemorrhoids before treatment, whenever possible. Hemorrhoid banding and infrared coagulation are both safe, effective, and easy to perform in the office setting and have similar benefits in the short term. Longer-term benefits for treatment of prolapsing hemorrhoids and recurrent bleeding are seen with rubber band ligation. For grades 1 to 3 hemorrhoids, the authors state that banding or infrared coagulation should be employed prior to surgical hemorrhoidectomy."Hemorrhoid banding and infrared coagulation are safe and effective modalities for the management of grade 1 and grade 2 hemorrhoids, and the decision to refer to a surgeon should be individualized," the authors write.Two authors disclosed ties to the biopharmaceutical industry.Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter

AGA Clinical Practice Update Provided for Diagnosis, Treatment of Hemorrhoids

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