1 Plant Archives Vol. 20, Supplement 1, 2020 pp. 3828-3837 e-ISSN:2581-6063 (online), ISSN:0972-5210 REVIEW ARTICLE RECENT MANAGEMENT OF HEMORRHOIDS : A PHARMACOLOGICAL & SURGICAL PERSPECTIVE Saurabh Gupta 1 , Thakur Gurjeet Singh 1* , Suman Baishnab 1 , Nidhi Garg 1 , Kiranjeet Kaur 1 and Saurabh Satija 2 1 Chitkara College of Pharmacy, Chitkara University, Punjab, India 2 School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India *Author for correspondence: E-mail: gurjeet.singh@chitkara.edu.in; gurjeetthakur@gmail.com Abstract Hemorrhoids, likewise called piles, are swollen veins in the anus and lower rectum, like varicose veins. Hemorrhoids are portrayed by the symptomatic broadening and distal dislodging of the ordinary anal cushions. Many components have been claimed to be the occurrences of hemorrhoidal development, including constipation and delayed straining. Hemorrhoid tissues are a system of veins situated in and around the anal trench (the last couple of inches of the rectum). At the point when these veins swell, the patient can have manifestations, for example, pain or a burning sensation, Bleeding amid bowel movement, Protrusion of tissue from the anus, Itching around the anus. Hemorrhoids are a standout amongst the most widely recognized reasons that patients look for consultation from a colon and rectal surgeon. Hemorrhoidal disorder has been recorded through hundreds of years of history. Primitive references are found in the Old Testament and in Egyptian, Babylonian and Greek composed sources. Although there are few treatment options available for the treatment of Hemorrhoids, but there is very less or limited knowledge about the complete treatment options and new treatment that are available for treating Hemorrhoids. This review article on Recent Advances in the Treatment of Hemorrhoids will unfold various options (both existing and novel) available for the management of this disorder. The aim stands to prevent morbidity and mortality if any due to this disorder. The review will also unfold management of hemorrhoids via surgical procedures. Keywords: Hemorrhoids, Piles, Internal Hemorrhoids, External Hemorrhoids, Treatment of Hemorrhoids. Introduction Hemorrhoids, likewise called piles, occurs in the anus and lower rectum due to swelled up veins, like varicose veins (Mayoclinic, 2019). Hemorrhoids are portrayed by the symptomatic broadening and distal dislodging of the ordinary anal cushions (Agrawal and Chopra, 2016). Many components have been claimed to be the occurrences of hemorrhoidal development, including constipation and delayed straining (Agboo, 2011). Hemorrhoid tissues are a system of veins situated in and around the anal trench (the last couple of inches of the rectum). At the point when these veins swell, the patient can have manifestations, for example, Pain or a burning sensation, Bleeding amid bowel movement, Protrusion of tissue from the anus, Itching around the anus (Krames Patient Education, 2010). Hemorrhoids are a standout amongst the most widely recognized reasons that patients look for consultation from a colon and rectal surgeon (Sanchez and Chinn, 2011). Hemorrhoidal disorder has been recorded through hundreds of years of history (Margetis, 2019). Primitive references are found in the Old Testament and in Egyptian, Babylonian and Greek composed sources (Holley, 1946; Senagore, 2002; Ellesmore & Windsor, 2002). Internal and Pathophysiological Aspects Hemorrhoids are ordinary structures of the human body (Mott et al., 2018; Ganz, 2013; Jacobs, 2014). Internal hemorrhoids emerge from the inward hemorrhoidal plexus, while outer hemorrhoids emerge from the outside plexus. The anatomical boundary that isolates the inward from the outside hemorrhoidal plexus is the dentate line (Sandler and Peery, 2019; Mott et al., 2018; Ganz, 2013). The typical inner hemorrhoidal plexus comprises of 3 delicate engorgements, alluded to as anal cushions or "hemorrhoids" (Jorge and Gama, 2011; Hyung, 2014). Consequently, the expression "internal hemorrhoids" does not imply a condition of disorder whenever seen in its severe strict definition. Be that as it may, in clinical practice the expression "internal hemorrhoids" is utilized to portray exclusively the disorder coming about because of the abnormal amplification of anal cushions, i.e., their change to anal nodules (Ganz, 2013; Jorge and Gama, 2011; Hyung, 2014). More specifically, this definition is restricted to symptomatic hemorrhoidal ailment: i.e., anal cushions are named "hemorrhoids" when they bleed as well as prolapse (Margetis, 2019). Fig. 1: Parts of Anal Canal (Krames Patient Education, 2010) 102