Editorial
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2019; 11(3): 117-121
Published online Mar 27, 2019. doi: 10.4240/wjgs.v11.i3.117
Classification and guidelines of hemorrhoidal disease: Present and future
Michele Rubbini, Simona Ascanelli
Michele Rubbini, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara 44121, Italy
Simona Ascanelli, Department of Surgery, Azienda Ospedaliero-Universitaria Sant’anna, Ferrara, Ferrara 44121, Italy
Author contributions: The authors contributed equally to this manuscript.
Supported by: Fondo Incentivazione per la Ricerca (FIR), University of Ferrara, Italy.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Michele Rubbini, MD, PhD, Academic Fellow, Associate Professor, Director, Programma di Chirurgia Coloproctologica, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Aldo Moro, 8 Cona, Ferrara 44121, Italy. rbb@unife.it
Telephone: +39-53-2688110
Received: March 8, 2019
Peer-review started: March 11, 2019
First decision: March 19, 2019
Revised: March 19, 2019
Accepted: March 20, 2019
Article in press: March 20, 2019
Published online: March 27, 2019
Abstract

Classification and guidelines of hemorrhoidal disease are based on the subdivision in Grades of prolapse followed by any aspect related to both the treatment and its technique. When taking the proposals for classification and guidelines issued by prolific scientific societies into consideration, it is evident that strong contradictions and interpretative limits emerge in finding the best treatment to be adopted. After a critical examination of these limitations, a methodological proposal is shared to achieve a new classification, which plays a part in forming a new guideline for hemorrhoidal disease, identifying its evolution, dynamism of the prolapse, symptomatology, enteropathogenesis and gender characteristics.

Keywords: Hemorrhoids, Calssification, Guidelines, Gender

Core tip: Hemorroidal disease is a common pathological entity, matter of discussion with regard to classification and guidelines. After a critical examination of these, a methodological proposal is shared to achieve a new classification, which plays a part in forming a new guideline for hemorrhoidal disease, identifying its evolution, dynamism of the prolapse, symptomatology, enteropathogenesis and gender characteristics.