Hemorrhoidal disease is a prevalent global health issue, with studies estimating its occurrence between 4% and 13% in the general population. In the United States, nearly 50% of individuals over the age of 50 experience hemorrhoidal symptoms at some point in their lives. Despite its high prevalence, the condition remains an underappreciated economic and public health burden. Rising healthcare costs further amplify the need for cost-effective and sustainable treatment strategies. In 2023, U.S. healthcare spending increased by 7.5%, reaching $4.9 trillion (17.6% of GDP), or $14,570 per person. Hemorrhoidal disease significantly contributes to this economic strain, with approximately 4 million diagnoses annually in ambulatory care settings, leading to multiple visits, procedural interventions, and lost productivity. Traditional treatment approaches primarily focus on anatomical correction, often neglecting long-term function preservation. While some procedures provide temporary relief, many patients experience recurrence, impaired continence, rectal sensitivity issues, and reduced quality of life. The lack of a standardized, function-preserving treatment paradigm results in inconsistent outcomes, higher retreatment rates, and increased healthcare utilization, further exacerbating the economic and clinical burden. The 5PF framework represents a scientifically grounded, patient-centered shift in hemorrhoid management. By prioritizing function preservation over mere anatomical correction, 5PF integrates patient needs, technological innovation, and sustainable healthcare practices. This approach addresses a critical gap in global treatment strategies—offering immediate symptom relief, reduced recurrence rates, and long-term value for both patients and healthcare systems. As a paradigm shift, 5PF aligns with modern healthcare priorities, optimizing outcomes while minimizing unnecessary interventions and economic costs. A deeper understanding of hemorrhoidal disease as a high-burden, high-cost condition is essential for improving treatment strategies, enhancing patient quality of life, and ensuring long-term healthcare sustainability. This pioneering initiative aims to recognize strengths, identify areas for improvement, and foster growth through a fair and transparent evaluation process.

Parshottambhai Patel – Surgeon, Researcher, and Innovator in Hemorrhoid Management Parshottambhai Patel, MS, ADIT, is a distinguished surgeon and cancer specialist with over four decades of experience in advancing surgical techniques and healthcare research. As the lead practitioner at Shiv Shraddha Nursing Home in Ahmedabad, India, he has dedicated his career to early cancer detection, hemorrhoidal disease management, and Vyasan Mukti Abhiyan (addiction-free living). A prolific author, Dr. Patel has written over 20 books and booklets and delivered more than 1,000 lectures across Gujarat, educating both medical professionals and the public on critical health issues. His groundbreaking work in hemorrhoid management led to the development of the 5PF framework, a paradigm shift focusing on Precise, Purposeful, Predictable, and Personalized fibrosis to preserve functions. Dr. Patel has contributed to academic literature, including writing the chapter "Cutting-Edge Strategies in Management of Hemorrhoids" in the book Diseases of the Rectum and Anus – A Concise Guide. https://www.intechopen.com/online-first/1210069 His research has been presented at prestigious international conferences such as SAGES and ASCRS in the USA, influencing global discussions on cost-effective, function-preserving surgical strategies. Committed to advancing medical science, Dr. Patel continues to pioneer sustainable, patient-centered approaches that improve outcomes and enhance quality of life worldwide.