Management of haemorrhoids

Hemorrhoids are one of the commonest of rectal diseases seen all across the globe. Constipation and bleeding are the main symptoms associated with this condition. The condition maybe associated with an underlying carcinoma as well. Understanding the pathophysiology will enable the surgeon to determine the best therapeutic option for this condition. A brief review of clinical evaluation and treatment options is presented in this paper.

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“…12 A sclerosant is injected into the submucosal layer. It elicits an inflammatory reaction followed by fibrosis.…”

Section: Nonoperative Treatmentmentioning

confidence: 99%

“…Hemorrhoidectomy: The traditional ligation-excision continues to be the best method. 12 It can either be done using scissors or by cautery dissection. Availability of newer energy sources have greatly enhanced surgical outcomes in these patients.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Hemorrhoids: which is the best therapeutic option?

et al. 2018

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“…Conservative treatment based on lifestyle changes such as dietary and exercise and laxatives can help the majority of patients, and rubber band ligation, sclerotherapy and phlebotonic drugs can effectively treat Grades Ⅰ and Ⅱ hemorrhoids [2] . Surgical treatment is required for the most advanced stages, Grade Ⅲ or Ⅳ and bleeding.…”

Section: Introductionmentioning

confidence: 99%

“…Surgical treatment is required for the most advanced stages, Grade Ⅲ or Ⅳ and bleeding. There are several methods of surgical treatment for hemorrhoids: Conventional hemorrhoidectomy (CH), stapled hemorrhoidopexy (PPH), and trans-anal hemorrhoidal dearterialization (THD) [1][2][3][4] . Among them, PPH and THD aim to correct the underlying pathophysiological mechanisms involved in the etiology of hemorrhoids.…”

Section: Introductionmentioning

confidence: 99%

Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades II and III hemorrhoids: Results from a multicenter study

Miyamoto¹,

Hada²,

Ishiyama³

et al. 2016

WJH

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AIM:To show that aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy has a high success rate for Grade Ⅱ and Ⅲ hemorrhoids. METHODS:This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015. The objective of this study was to assess the efficacy of this treatment for Grades Ⅱ and Ⅲ hemorrhoids. Preoperative and postoperative symptoms, complications and success rate were all assessed retrospectively. Follow-up consisted of a simple questionnaire, physical examination and an anoscopy. Patients were followed-up at one day, one week, two weeks, one month, one year, two years, three years, four years and five years after the ALTA sclerotherapy. RESULTS:One hundred and sixty-nine patients were diagnosed with Grade Ⅱ hemorrhoids and 435 patients were diagnosed with Grade Ⅲ hemorrhoids. The one year, three year and five year cumulative success rates of ALTA sclerotherapy for Grades Ⅱ and Ⅲ hemo- Retrospective Study 845July 18, 2016|Volume 8|Issue 20| WJH|www.wjgnet.com Miyamoto H et al . ALTA sclerotherapy for Grade Ⅱ and Ⅲ hemorrhoids rrhoids were 95.9% and 93.1%; 89.3% and 83.7%; and 89.3% and 78.2%, respectively. No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between Grades Ⅱ and Ⅲ hemorrhoids (P = 0.09). There were forty-seven post-operative complications (low grade fever; anal pain; urinary retention; rectal ulcer; and others). No serious or life-threatening complications occurred and all cases improved through conservative treatment. At univariate analysis there were no predictive factors of failure. CONCLUSION:ALTA sclerotherapy has had a high success rate for Grade Ⅱ and Ⅲ hemorrhoids during five years of post-operative treatment. However, additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease.

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“…4 In the treatment of first and second degree piles methods like sclerotherapy, infrared coagulation or cryotherapy may be helpful in 90% patients. 1,5 Sclerotherapy is time-honoured, outpatient procedure that is widely practiced globally to treat haemorrhoids. It started about one and a half century ago and was first advocated in US by Blackwood in 1866.…”

Section: Introductionmentioning

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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Management of haemorrhoids

Cited by 118 publications

References 24 publications

Hemorrhoids: which is the best therapeutic option?

Hemorrhoids: which is the best therapeutic option?

Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades II and III hemorrhoids: Results from a multicenter study

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

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