subject: Common Office Treatments For Hemorrhoids [print this page] Hemorrhoids are common problem, and as such there are a variety of treatments available depending on hemorrhoids' severity, the expense you can afford, and how effective they are. Whether or not a particular treatment will work for a particular patient depends as well on whether or not the patient's values support it. In general, office treatments used for hemorrhoids today are infrared photocoagulation, sclerotherapy, bicap coagulation, rubber band ligation, and, occasionally, cryotherapy.
Among the most common of treatments used is rubber band ligation. It's used for second-degree internal hemorrhoids and is usually done on an outpatient basis. With rubber band ligation, a small band is wrapped around the base of the hemorrhoid so that blood flow is impeded to the hemorrhoidal mass itself.
Within 2 to 7 days, the shriveled hemorrhoids will then dry up and die. After that, the desiccated hemorrhoid and rubber band will fall off during normal bowel movements. In addition to a shorter recovery period, rubber band ligation is the most popular method because involves little pain than other surgical treatments.
In the process of infrared photocoagulation, the coagulator creates infrared radiation, which clots tissue protein while evaporating water from cells. The measure of the treatment will depend on how intense and how long the infrared is applied. It is intended to decrease blood flow to the region but is not predominantly effective in treating big amounts or prolapsing tissue hence it is most useful in treating Grade I and slight Grade II hemorrhoids. It is more popular than the rubber band ligation because it is less painful.
Whether in the operating room or in the office, bipolar coagulation is generally the treatment of choice if precise coagulation needed. That's because it penetrates less than the standard monopular cautery does, and it utilizes the same treatment theory such as that used by rubber band ligation or infrared photocoagulation. That is, the bicap probe is placed upon the apex of the hemorrhoid and left there for 10 minutes. It's not especially effective for patients who have poor tolerance for pain, or for sitting still for that long; if patients don't finish the session, its effect is reduced.
With the use of rubber band ligation, sclerotherapy, also called injection therapy, is less used than in previous years. At one time, though, it was a very common treatment for hemorrhoids. With this treatment, an irritating substance, called a sclerosant, is injected into the hemorrhoid; this helps reduce vascularity. As with the other treatments, this is supposed to help decrease blood flow into the mass. Substances that have been injected include quinine urea or sodium morrhuate.
As with other office treatments, the hemorrhoid is first located using an anoscope and then these substances injected at the mass' apex, at the near anal rectal ring. Usually, this is not going to result in bleeding or other complications, but you may experience a dull ache after you've had this procedure for about a day or two.
As with sclerotherapy, cryotherapy has fallen out of favor. In previous years, the apex of the anal canal was frozen with the theory that vascularity and fibrosis of the anal cushion would be reduced. However, the treatment was not very successful because it triggered the production of a "smelly" discharge. It was also quite painful and healed quite slowly, so that most medical practitioners subsequently abandoned it.
