{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:45:16Z","timestamp":1792478716069,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T00:00:00Z","timestamp":1724198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>There is no universally accepted treatment consensus for haemorrhoids, and thus, management has been individualized all over the world. This study was conducted to assess a global view of how surgeons manage haemorrhoids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The research panel of the International Society of University Colon and Rectal Surgeons (ISUCRS) developed a voluntary, anonymous questionnaire evaluating surgeons' experience, volume and treatment approaches to haemorrhoids. The 44 multiple\u2010choice questionnaire was available for one\u2009month via the ISUCRS email database and the social media platforms Viber and WhatsApp.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The survey was completed by 1005 surgeons from 103 countries; 931 (92.6%) were in active practice, 819 (81.5%) were between 30 and 60\u2009years of age, and 822 (81.8%) were male. Detailed patient history (92.9%), perineal inspection (91.2%), and digital rectal examination (91.1%) were the most common assessment methods. For internal haemorrhoids, 924 (91.9%) of participants graded them I\u2013IV, with the degree of haemorrhoids being the most important factor considered to determine the treatment approach (76.3%). The most common nonprocedural\/conservative treatment consisted of increased daily fibre intake (86.9%), increased water intake (82.7%), and normalization of bowel habits\/toilet training (74.4%). Conservative treatment was the first\u2010line treatment for symptomatic first (92.5%), second (72.4%) and third (47.3%) degree haemorrhoids; however, surgery was the first\u2010line treatment for symptomatic fourth degree haemorrhoids (77.6%). Rubber band ligation was the second\u2010line treatment in first (50.7%) and second (47.2%) degree haemorrhoids, whereas surgery was the second\u2010line treatment in third (82.9%) and fourth (16.7%) degree symptomatic haemorrhoids. Rubber band ligation was performed in the office by 645(64.2%) of the participants. The most common surgical procedure performed for haemorrhoids was an excisional haemorrhoidectomy for both internal (87.1%) and external (89.7%) haemorrhoids \u2013 with 716 (71.2%) of participants removing 1, 2 or 3 sectors as necessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although there is no global haemorrhoidal treatment consensus, there are many practice similarities among the different cultures, resources, volume and experience of surgeons around the world. With additional studies, a consensus statement could potentially be developed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.17140","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T04:44:01Z","timestamp":1724301841000},"page":"1797-1804","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Global treatment of haemorrhoids\u2014A worldwide snapshot audit conducted by the International Society of University Colon and Rectal Surgeons"],"prefix":"10.1111","volume":"26","author":[{"given":"Narimantas E.","family":"Samalavicius","sequence":"first","affiliation":[{"name":"Department of Surgery Republican Vilnius University Hospital  Vilnius Lithuania"},{"name":"Faculty of Medicine, Institute of Clinical Medicine Vilnius University  Vilnius Lithuania"},{"name":"Hila, Medical Diagnostics and Treatment Center  Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh Kumar","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Surgery Gastrointestinal Unit, B.P. Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Nunoo\u2010Mensah","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery King's College Hospital Foundation NHS Trust  London UK"},{"name":"Cleveland Clinic  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Allegheny General Hospital  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2252-9509","authenticated-orcid":false,"given":"Varut","family":"Lohsiriwat","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhawani","family":"Khanal","sequence":"additional","affiliation":[{"name":"Department of Surgery Gastrointestinal Unit, B.P. Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhijeet","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Surgery Gastrointestinal Unit, B.P. Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bikash","family":"Sah","sequence":"additional","affiliation":[{"name":"Department of Surgery Gastrointestinal Unit, B.P. Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dovile","family":"Cerkauskaite","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Institute of Clinical Medicine Vilnius University  Vilnius Lithuania"},{"name":"Department of Surgical Oncology National Cancer Institute  Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3692-8962","authenticated-orcid":false,"given":"Audrius","family":"Dulskas","sequence":"additional","affiliation":[{"name":"Department of Surgery Republican Vilnius University Hospital  Vilnius Lithuania"},{"name":"Department of Surgical Oncology National Cancer Institute  Vilnius Lithuania"},{"name":"SMK, University of Applied Social Sciences  Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"2023 International Society of Universities of Colon and Rectal Surgeons (ISUCRS) Collaborating Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0249736"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016\u20105085(90)90828\u2010O"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2217\/cer\u20102020\u20100159"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1272818"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001030"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14975"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.16078"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6113"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)30584\u20100"},{"issue":"12","key":"e_1_2_10_11_1","first-page":"1","article-title":"Diagnosis and treatment of haemorrhoids","volume":"60","author":"Buntzen S","year":"2013","journal-title":"Dan Med J"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v7.i22.3742"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6.3.e34"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12262\u2010016\u20101578\u20107"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010020\u201002149\u20101"},{"issue":"3","key":"e_1_2_10_16_1","first-page":"172","article-title":"Hemorrhoids: diagnosis and treatment options","volume":"97","author":"Mott T","year":"2018","journal-title":"Am Fam Physician"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.51821\/84.1.497"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.12.020"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.17140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T05:45:26Z","timestamp":1729057526000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.17140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,21]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1111\/codi.17140"],"URL":"https:\/\/doi.org\/10.1111\/codi.17140","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,21]]},"assertion":[{"value":"2024-01-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}