**7. Summary**

Hemorrhoids are frequently encountered in clinical practice, and physicians must be well-versed in the pathogenesis, risk factors, correct diagnosis, and correct management for patients to receive the best care and recover. The anal cushion sliding theory is now well accepted in the pathogenesis of hemorrhoids and is mostly related to constipation. Therefore, in the management of hemorrhoids, prevention or treatment of constipation has an important place. The first choice for preventing or treating constipation is to eat a high-fiber diet and drink plenty of water. Flavanoids, as oral medication, can be added since they have already been demonstrated to reduce hemorrhoid signs and symptoms. In the case of grades I, II, or small grades III, which fail in medicamentous treatment, instrumentation can be offered, and rubber band ligation is the best choice due to its effectiveness and low price. Surgery is the treatment of choice in emergency cases (thrombosis, strangulation, or bleeding that fails with other treatments) and in cases of grade III and IV that fail nonsurgical management. The gold standard of hemorrhoid surgery is excisional surgery, namely Morgan Milligan and Ferguson. Ferguson is slightly superior to Morgan Milligan regarding postoperative pain, bleeding, and speed of healing. Since excisional surgery is painful, nowadays it offers anal cushion preserving surgery. They are stapler hemorrhoidopexy (SH), hemorrhoidal artery ligation, and rectoanal repair under the guidance of Doppler (DG HAL-RAR). Both methods were comparable regarding the length of operative time, bleeding complications, and recurrence. But only regarding postoperative pain, DG HAL-RAR was superior to SH. DG HAL-RAR and SH also had less postoperative pain but higher recurrence compared to excisional surgery. Based on its advantages and disadvantages, let the patient choose the method of surgery.

*Prolapsing Hemorrhoids DOI: http://dx.doi.org/10.5772/intechopen.104554*
