Conservative management of symptomatic and/or complicated haemorrhoids in pregnancy and the puerperium

Hemorrhoids are one of the most common medical and surgical diseases and the main reason for a visit to a coloproctologist. This consensus statement was drawn up by the Italian society of colorectal surgery in order to provide practice parameters for an accurate assessment of the disease and consequent appropriate treatment. The authors made a careful search in the main databases (MEDLINE, PubMed, Embase and Cochrane), and all results were classified on the basis of the grade of recommendation (A-C) of the American College of Chest Physicians.

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“…Rutosides seem to be effective in reducing symptoms of hemorrhoids in pregnant women [91] (Level of evidence I; Grade of recommendation: B).…”

Section: Conservative Treatmentmentioning

confidence: 99%

Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement

Trompetto¹,

Clerico²,

Cocorullo

et al. 2015

Tech Coloproctol

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“…Consequently, long-term use of steroidal ointments/suppositories is contraindicated 63) . The use of flavonoids in pregnant women has not been sufficiently evaluated; however, there is one case report of a fetal death and one of a birth defect, indicating that this treatment may not be completely safe 64) .…”

Section: ) Drug Therapy and Pregnancymentioning

confidence: 99%

Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

Yamana

2017

J Anus Rectum Colon

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The pathogenesis of hemorrhoids is a weakening of the anal cushion and spasm of the internal sphincter. Bowel habits and lifestyles can be risk factors for hemorrhoids. The prevalence of hemorrhoids can encompass 4 to 55% of the population. Symptoms include bleeding, pain, prolapsing, swelling, itching, and mucus soiling. The diagnosis of hemorrhoids requires taking a thorough history and conducting an anorectal examination. Goligher's classification, which indicates the degree of prolapsing with internal hemorrhoids, is useful for choosing treatment. Drug therapy for hemorrhoids is typically utilized for bleeding, pain, and swelling. Ligation and excision (LE) is considered for Grade III and IV internal and external hemorrhoids. Rubber band ligation is used to treat up to Grade III internal hemorrhoids. Phenol almond oil is effective for internal hemorrhoids up to Grade III, while aluminum potassium sulfate and tannic acid have shown efficacy in treating prolapsing in internal hemorrhoids at Grades II, III, and IV. Procedure for prolapse and hemorrhoids (PPH) is surgically effective for Grade III internal hemorrhoids; however, the long-term prognosis is not favorable, with high recurrence rates. Separating ligation is effective surgical treatment for internal/external hemorrhoids Grade III and Grade IV. The basic approach to thrombosed external hemorrhoids and incarcerated hemorrhoids is conservative treatment; however, in some acute or severe cases, surgical resection is considered. Comparing the different instruments used for hemorrhoid surgery, all reduce operating time, blood loss, post-operative pain, and length of time until the return to normal activity. They do, of course, increase the cost of the procedure.

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“…Induration is the indicator of proper depth. 18 The most common sclerosing agent used is 5% Phenol in Almond oil, which is mainly effective for haemorrhage. 19 Other agents include Phenol in Arachis oil, Polidocanol, Quinine and Urethane, Aetoxisclerol, Xiao Zhi Ling (XZL) (Consisting of Chinese nutgalls and Aluminium Potassium Sulphate), OC 108 and 50% Dextrose.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study on Role of Sclerotherapy in Management of First and Second Degree Haemorrhoids

Ambedkar¹,

Singh²,

Gaharwar³

et al. 2016

jemds

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AIM AND OBJECTIVETo find out the safety and efficacy of sclerotherapy in management of symptomatic first and second degree haemorrhoids. PATIENTS AND METHODSTotal 53 patients of both genders were selected with diagnosis of symptomatic first or second degree haemorrhoids, all of them were subjected for injection sclerotherapy and procedure repeated as per need. Patients were assessed at 1 week, 1 month, 3 months and 6 months thereafter. RESULTSBleeding stopped in 94.3% of the patients after treatment at 6 months follow-up with early and smooth recovery without any significant morbidity. CONCLUSIONThis prospective study concluded sclerotherapy as a safe, easy, cheap and effective method of treatment of first degree and early second degree haemorrhoids devoid of any significant complications. KEYWORDSHaemorrhoids, Sclerotherapy, First Degree Haemorrhoids, Second Degree Haemorrhoids, Rubber Band Ligation, Anorectal Symptoms. HOW TO CITE THIS ARTICLE:Ambedkar V, Singh A, Gaharwar APS, et al. A prospective study on role of sclerotherapy in management of first and second degree haemorrhoids.

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Conservative management of symptomatic and/or complicated haemorrhoids in pregnancy and the puerperium

Cited by 50 publications

References 13 publications

Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement

Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement

Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

A Prospective Study on Role of Sclerotherapy in Management of First and Second Degree Haemorrhoids

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