What Office Treatments Are Available for Hemorrhoids?

By: Richard Hill


Hemorrhoid treatments vary in their expenditure, risk, and effectiveness. The approach to a specific treatment also depends on the patient's belief and culture. Office treatments are made up of various methods short of surgical intervention. The generally used office treatments today are rubber band ligation, infrared photocoagulation, bicap coagulation, sclerotherapy, and not often, 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 about two to seven days, the hemorrhoid itself will shrivel and then dry up and die. After that, the hemorrhoid, now desiccated, and the rubber band will usually fall off during normal bowel movements. This treatment has a short recovery period and is the most popular because it involves relatively little pain as opposed to 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.
In the operating room or in office treatment, if precise coagulation is necessary as it penetrates less than the standard monopolar cautery, bipolar coagulation is usually utilized. It also utilizes the treatment theory like that of the rubber band ligation and the infrared photocoagulation. On the apex of the hemorrhoid, the bicap probe is placed and left for ten minutes. The procedure has a bit difficulty to patients with poor tolerance who don't finish the set time thus reducing its effect.
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.
Similar to the other office treatments, the hemorrhoids is first identified using an anoscope then the substance is injected at the apex of the mass at the near anal rectal ring. Although it will seldom result to bleeding or other complications, a dull ache will be experienced for about a day or two.
Cryotherapy has been out of favor, as has sclerotherapy, with the advent of rubber band ligation. Previously, it was thought that freezing the apex of the anal canal would reduce anal cushion vascularity and induce fibrosis. However, the treatment causes a very unpleasant-smelling discharge, and it's also quite painful. In addition, because it's quite slow to heal, most medical practitioners have quit using it.

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