out within 24–72 hours. evidence to support this is weak, however. glyceryl trinitrate ointment after the procedure helps both with pain and with healing. doppler-guided transanal hemorrhoidal dearterialization is a minimally invasive treatment using an ultrasound doppler to accurately locate the arterial blood inflow. these arteries are then "tied off" and the prolapsed tissue is sutured back to its normal position. it has a slightly higher recurrence rate but fewer complications compared to a hemorrhoidectomy. stapled hemorrhoidectomy, also known as stapled hemorrhoidopexy, involves the removal of much of the abnormally enlarged hemorrhoidal tissue, followed by a repositioning of the remaining hemorrhoidal tissue back to its normal anatomical position. it is generally less painful and is associated with faster healing compared to complete removal of hemorrhoids. however, the chance of symptomatic hemorrhoids returning is greater than for conventional hemorrhoidectomy, so it is typically recommended only for grade ii or iii disease. epidemiology it is difficult to determine how common hemorrhoids are as many people with the condition do not see a healthcare provider. however, symptomatic hemorrhoids are thought to affect at least 50% of the us population at some time during their lives, and around 5% of the population is affected at any given time. both sexes experience about the same incidence of the condition, with rates peaking between 45 and 65 years. they are more common in caucasians and those of higher socioeconomic status. long-term outcomes are generally good, though some people may have recurrent symptomatic episodes. only a small proportion of persons end up needing surgery. history an 11th-century english miniature. on the right is an operation to remove hemorrhoids. the first known mention of this disease is from a 1700 bce egyptian papyrus, which advises: "... thou shouldest give a recipe, an ointment of great protection; acacia leaves, ground, titurated and cooked together. smear a strip of fine linen there-with and place in the anus, that he recovers immediately." in 460 bce, the hippocratic corpus discusses a treatment similar to modern rubber band ligation: "and hemorrhoids in like manner you may treat by transfixing them with a needle and tying them with very thick and woolen thread, for application, and do not foment until they drop off, and always leave one behind; and when the patient recovers, let him be put on a course of hellebore." hemorrhoids may have been described in the bible, with earlier english translations using the now-obsolete spelling "emerods". celsus (25 bce – 14 ce) described ligation and excision procedures and discussed the possible complications. galen advocated severing the connection of the arteries to veins, claiming it reduced both pain and the spread of gangrene. the susruta samhita (4th–5th century bce) is similar to the words of hippocrates, but emphasizes wound cleanliness. in the 13th century, european surgeons such as lanfranc of milan, guy de chauliac, henri de mondeville, and john of ardene made great progress and development of the surgical techniques. in medieval times, hemorrhoids were also known as saint fiacre's curse after a sixth-century saint who developed them following tilling the soil. the first use of the word "hemorrhoid" in english occurs in 1398, derived from the old french "emorroides", from latin hæmorrhoida, in turn from the greek αἱμορροΐς (haimorrhois), "liable to discharge blood", from αἷμα (haima), "blood" and ῥόος (rhoos), "stream, flow, current", itself from ῥέω (rheo), "to flow, to stream". notable cases hall-of-fame baseball player george brett was removed from a game in the 1980 world series due to hemorrhoid pain. after undergoing minor surgery, brett returned to play in the next game, quipping, "my problems are all behind me". brett underwent further hemorrhoid surgery the following spring. conservative political commentator glenn beck underwent surgery for hemorrhoids, subsequently describing his unpleasant experience in a widely viewed 2008 youtube video. former u.s. president jimmy carter had surgery for hemorrhoids in 1984. cricketers matthew hayden and viv richards have suffered the condition. during world war ii, us army lieutenant colonel harold cohen was selected by general george s. patton to organize a raid to rescue patton's son-in-law from a german prison camp; cohen was prevented from leading the raid due to hemorrhoids. patton personally examined cohen and remarked, "that is some sorry ass".