Diagnosis and Contemporary Management of Hemorrhoids A

13 INTRODUCTION Most physicians perceive hemorrhoids as pathologic. In fact, hemorrhoids are normal anatomic structures, as demonstrated by their presence in babies (1). Patients and physicians may initially ascribe symptoms of rectal bleeding and pain to hemorrhoids without considering the other likely and more dangerous possibilities such as colorectal cancer. Hemorrhoidal disease is clearly important in so far as symptoms are common; however, other pathologic states may mimic hemorrhoidal symptoms. A detailed patient history, coupled with a relatively simple office-based examination, is usually sufficient to establish hemorrhoidal disease as the cause of a patient’s symptoms.