Hemorrhoidal Disease Classification Methods: Recent Advances and Value Analysis

As a common anorectal disease, the high incidence and recurrence of hemorrhoidal disease impose pressure on both doctors and patients. Hemorrhoidal disease assessment is a necessary prerequisite for diagnosis and selection of appropriate treatment options. Objective assessment of hemorrhoidal disease and selection of an appropriate treatment are strong concerns of clinicians, and many hemorrhoidal disease classification methods have been developed recently. We reviewed these recently emerged hemorrhoidal disease classification methods, which mainly include prolapse-dominated classification methodologies (Goligher classification, Indian new classification algorithm of haemorrmoids, single pile classification, algorithm for grading prolapsing haemorrhoids), bleeding-dominated classification methodologies (Japanese endoscopic classification of internal hemorrhoids, PNR-bleeding classification), and comprehensive classification methodologies[Lunniss's classification of internal haemorrhoids, anatomical/clinical-therapeutic classification, BPRST classification, BPECT classification, four-factors (PBCE) hemorrhoids classification], then analyzed evaluation values, essential factors, principles of use and components of assessment indicators of the methods. Afterwards, we put forward optimization strategies targeting their limitations and predicted their possible future development directions. All these will provide a reference for the development regarding the assessment and classification of hemorrhoids and clinical diagnosis and management of hemorrhoids.