Hemorrhoids and Crohn's disease

Hemorrhoidal disease is the most common condition encountered in proctology. Admittedly it is not the most frequent perianal pathology in Crohn's disease since it represents only 1 to 2% of all perianal attacks. However its optimal treatment remains controversial due to the lack of scientific evidence available in the literature. According to old data from 1970 and 1980 the use of proctectomy is inevitable after hemorrhoidectomy in patients with Crohn's disease. Through this review of the literature hemorrhoidectomy is no longer formally prohibited in a patient with Crohn's disease due to the low rate of postoperative complications. This is particularly true after failure of conservative treatments and when the disease is quiescent. However data from larger-scale prospective and comparative studies are needed to guide the therapeutic strategy.