Abstract
Usually, medical treatment alone is indicated as first treatment. It is estimated that only 10% of patients will need surgical treatment. Classical recommendations toward suppression of spices, alcohol, tobacco, and coffee... are not founded on scientific proofs. Usage of cold and hot sitz baths are sometimes advocated; it is no more validated by medical evidence. Bowel regularisation (prescription of fibres) is efficacious on haemorrhoidal symptoms in nearly 50% of patients. Non-steroidal anti-inflammatory drugs are probably the most efficacious for pain and oedema in external thrombosis.
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