HEMORRHOID DISEASE: DIAGNOSIS TREATMENT AND COMPLICATION MANAGEMENT

Hemorrhoidal_Disease_Bahadir_Egekapak

HISTORY OF HEMORRHOIDAL DISEASE

Gökay Çetinkaya

Kartal Dr. Lütfi Kırdar City Hospital, Department of General Surgery, İstanbul, Türkiye

Çetinkaya G. History of Hemorrhoidal Disease. In: Ege B, editor. Hemorrhoidal Disease: Diagnosis, Treatment and Complication Management. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.3-14.

ABSTRACT

Hemorrhoidal disease has held a significant place among anorectal pathologies throughout history leading to the development of various treatment methods over time. First documented around 1700 BCE in the Edwin Smith papyrus, this disease was initially treated with creams derived from acacia leaves. In 460 BCE, Hippocrates was the first to propose surgical treatment for this condition. During the Roman era, the physician Celsus described a technique to ligate hemorrhoids using linen thread, while Galen recommended ligation of hemorrhoidal piles alongside leech and ointment therapies. In the Middle Ages, as trust in surgery declined physicians favored less invasive treatments. In the 15th century, Serefeddin Sabuncuoğlu identified constipation as the primary cause of hemorrhoidal disease emphasizing the importance of rectal touch. In the 18th century, Giovanni Battista Morgagni explored the role of genetic predisposition and venous structure in the disease’s etiology. The 19th century saw the establishment of specialized centers for anorectal diseases facilitating the development of innovative treatments such as anal dilatation and sclerotherapy. Walter Whitehead described the circumferential excision technique, while Joseph Mathews implemented the ligation method. In the 20th century, Milligan-Morgan pioneered open hemorrhoidectomy and Sir Alan Parks developed the submucosal hemorrhoidectomy. Antonio longo’s introduction of stapled hemorrhoidectomy in 1998 marked a revolutionary advancement for cases involving prolapse. Today, treatment options are selected based on the disease stage with venotonic drugs, minimally invasive procedures and advanced surgical techniques like doppler-guided hemorrhoidal artery ligation minimizing complication rates. Hemorrhoid treatment varies with the stage, symptoms and overall health of the patient, yet hemorrhoidal disease has proven historically impactful, extending beyond individual affliction to influence major events. Many prominent figures have suffered from this condition, which has even contributed to the loss of significant battles and shifts in national destinies. As such, the historical significance of hemorrhoidal disease has played a crucial role in the advancement of medical science and technology, spurring interest from pharmaceutical companies and medical manufacturers and promoting the development of innovative treatment methods. Surgeons, as in the past, continue to advance their expertise and contribute to new therapeutic approaches to manage this condition.f

Keywords: Hemorrhoidal disease; Edwin Smith papyrus; Hemorrhoidectomy; Milligan-morgan; ligation

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