Arterial flow in healthy individuals and patients with hemorrhoidal disease: a Doppler ultrasound–based pathophysiological analysis

Abstract Background To evaluate arterial flow patterns in healthy individuals and patients with hemorrhoidal disease (HD) using Doppler transperineal ultrasound (TPUS), aiming to clarify the vascular contribution to HD pathophysiology. Methods A prospective observational study was conducted on 50 healthy controls (HC) and 94 HD patients classified by Goligher grade. All underwent TPUS with Doppler assessment to record vascular patterns and quantify peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI). Results A vascular Doppler pattern was observed in 92.6% of HD patients vs. 50% of HCs ( p < 0.001). HD patients showed significantly higher PSV (11.1 ± 3.6 cm/s vs. 8.3 ± 2.9 cm/s, p < 0.001) and RI (0.8 ± 0.1 vs. 0.7 ± 0.1, p = 0.015), with no significant difference in EDV. Among Goligher groups, grades III and IV showed significantly elevated PSV compared to HCs. No differences were observed in EDV or RI among subgroups. Conclusion Doppler TPUS can identify distinct hemodynamic profiles in HD patients, supporting a vascular component in HD pathogenesis. Its ability to detect subclinical alterations and distinguish severity grades may enhance diagnostic accuracy and guide tailored treatment strategies.