Anorectal disorders such as hemorrhoidal disease and fissures are exceedingly common. In fact, the Italian Society of Coloproctology (S.I.C.C.R.) states that over 50% of the Western adult population suffers or has suffered from hemorrhoidal pathology. The latter is, in fact, the most common cause of distress in the anorectal junction.
Hemorrhoids are venous cushions in the lower rectum, which contribute to the maintenance of fecal continence mechanisms, swelling and deflating depending on the situation. They are, therefore, normal structures of the anorectum that are naturally anatomically present. Only when symptoms such as swelling, bleeding and protrusions along the anal canal occur do they create a pathological condition defined as hemorrhoidal disease. Internal hemorrhoids are graded into four stages of increasing severity based on the degree of prolapse (Goligher’s classification):
- GRADE I
- GRADE II
- GRADE III
- GRADE IV
When we talk about a fissure, however, we refer to the appearance of a lesion in the anal canal, similar to an ulcer.