**1. Introduction**

Hemorrhoids are a disease of the anorectal area, that is often found in clinical practice, it is an enlargement and prolapsing (shift to the distal) of the anal cushion that gives clinical signs and symptoms [1]. Dilation and deformity of the blood vessels in the anal cushions, accompanied by destruction of the supporting tissues are the main pathological conditions of hemorrhoids. Inflammatory reactions and hyperplasia of blood vessels can also be found in hemorrhoids [2, 3].

Patients with complaints of bloody stools or anal discomfort are often caused by hemorrhoids, but the exact prevalence is unknown and will be lower than reality because many are under-reported and patients are self-medicating. The prevalence varies greatly from country to country, depending on the recording system. Data in the United States in 1990 showed that more than 10 million people suffered from hemorrhoids, or about 4.4% of the total population, while in the UK it was reported to be 13–36% of the general population [3]. The prevalence of men and women is comparable, and mostly occurs at the age of 45–65 years. White and high socioeconomic populations are more frequently affected than blacks and low socioeconomic populations [2].

Considering that hemorrhoids are the most common anal canal abnormalities and also the reason for patients' visits to the doctor or physician, a deep understanding of

the anatomy, physiology, pathogenesis, risk factors, diagnosis, and rational management is needed for doctors, to be able to treat hemorrhoids correctly and effectively, so that the patient is protected from irresponsible hemorrhoid management practices.
