Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	107099
Country	India

Category	Gastroenterology & Hepatology
Manuscript Type	Opinion Review
Article Title	TONEFACT: Can even advanced hemorrhoids be treated without surgery? A paradigm shift in the management of hemorrhoids
Manuscript Source	Invited Manuscript
All Author List	Pankaj Garg, Inna Tulina, Dong-Lin Ren, Kaushik Bhattacharya, Vipul D Yagnik and G Mahak
Funding Agency and Grant Number
Corresponding Author	Pankaj Garg, Department of Colorectal Surgery, Garg Fistula Research Institute, 1042, Sector-15, Panchkula 134113, Haryana, India. drgargpankaj@gmail.com
Key Words	Hemorrhoids; Fiber; Water intake; Non-surgical; Conservative management
Core Tip	Hemorrhoids are one of the most prevalent disorders. A lot of hemorrhoids patients are operated on, especially in advanced grades (late grade II, grade III & grade IV) and hemorrhoids with uncontrolled bleeding. TONEFACT is a novel treatment that rectifies the root cause of hemorrhoids, thereby stopping the progression and causing the cessation of symptoms (bleeding and thrombosis). Thus, it removes the requirement of surgery in a good proportion of patients who had been advocated surgery. Considering the high prevalence rate of the disease, this amounts to enormous savings in hospital admission and surgical morbidity at the global level.
Citation	Garg P, Tulina I, Ren DL, Bhattacharya K, Yagnik VD, Mahak G. TONEFACT: Can even advanced hemorrhoids be treated without surgery? A paradigm shift in the management of hemorrhoids. World J Gastrointest Surg 2025; In press

Received	2025-03-16 05:13
Peer-Review Started	2025-03-16 05:14
To Make the First Decision
Return for Revision	2025-04-02 13:25
Revised	2025-04-23 05:51
Second Decision	2025-05-28 02:40
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-05-28 08:32
Articles in Press	2025-05-28 08:32
Publication Fee Transferred
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9366 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Copyright	© The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Permissions	For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
Publisher	Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Website	http://www.wjgnet.com