History of Hemorrhoid Treatment
Hemorrhoids are one of the oldest documented medical conditions, referenced in texts thousands of years old — and the evolution of their treatment reflects the broader history of surgery moving toward less invasive, better-tolerated approaches.
- Hemorrhoids have been described in medical and religious texts for thousands of years, including ancient Egyptian and biblical references.
- Early surgical treatment was excisional and painful; the 20th century introduced the Milligan-Morgan and Ferguson techniques still used today.
- Recent decades have focused on developing less invasive alternatives (banding, stapling, laser, embolization) that reduce pain and recovery time.
Ancient references
Hemorrhoids appear in some of the oldest surviving medical writing, including ancient Egyptian medical papyri describing treatments for anal ailments, and biblical references (including in the Book of Samuel and Deuteronomy) to afflictions widely believed to describe hemorrhoids. This isn’t a niche modern condition — it’s been a recognized, documented human ailment for millennia.
Early surgical approaches
For much of medical history, treatment options were limited and often crude by modern standards — including cauterization, ligation with primitive materials, and various excisional techniques with significant associated pain and risk, reflecting the broader state of surgery before modern anesthesia and antiseptic technique.
The 20th century: modern excisional technique
The Milligan-Morgan technique, described in 1937, became one of the most widely adopted approaches to excisional hemorrhoidectomy and remains in use today (see Milligan-Morgan vs. Ferguson technique). The Ferguson (closed) modification followed, becoming particularly favored in North America.
The shift toward less invasive options
Starting in the mid-to-late 20th century and accelerating in recent decades, a range of less invasive alternatives emerged specifically to reduce the pain and recovery burden of traditional surgery:
- Rubber band ligation became a standard, widely available office procedure
- Stapled hemorrhoidopexy (PPH), introduced by Longo in 1998, offered a less painful surgical alternative for prolapsing disease
- More recent techniques — Doppler-guided artery ligation (HAL-RAR), laser hemorrhoidoplasty, and hemorrhoidal artery embolization — represent continued efforts to reduce pain and recovery time further, each with its own trade-offs covered in this site’s procedures and surgery sections
Why this history is relevant today
Understanding that treatment has consistently evolved toward less invasive options helps explain the current landscape: multiple options exist today specifically because the field has continued working to reduce the pain associated with older techniques, while the most durable option (traditional excisional surgery) remains available for situations where its lower recurrence rate matters more than recovery ease.
Where the field seems to be heading
Continued development of less invasive, tissue-preserving techniques (laser, embolization) suggests the trend toward reducing recovery burden will likely continue, even as traditional excisional surgery remains the reference standard for the most advanced disease given its still-superior long-term durability.
This page is for general education and historical context.