29/07/2024
Hemorrhoid Treatment Methods
Here are the treatment methods for hemorrhoids, depending on the symptoms:
Medical Treatment
Conservative Treatment and Lifestyle Adjustments
High-Fiber Diet: Effective for treating bleeding hemorrhoids; it also helps avoid irritants like alcohol and spicy foods. Avoid strenuous activities, prolonged sitting, or standing. Change bowel habits to prevent constipation.
Warm Sitz Baths: Sitting in warm water can help alleviate symptoms.
Medications: Topical ointments, suppositories, and medications that support venous circulation can be used.
Surgical Treatment
Thrombosed Hemorrhoid Management: Early intervention is recommended for thrombosed hemorrhoids. This can involve traditional surgical excision or combined procedures to remove the thrombosis and the hemorrhoid.
Rubber Band Ligation or Sclerotherapy: Often used for less severe cases. Rubber band ligation involves placing a rubber band around the hemorrhoid to cut off blood supply, leading to the hemorrhoid shrinking and falling off. Sclerotherapy involves injecting a sclerosing agent into the hemorrhoid to shrink it.
Sclerotherapy Indications:
Suitable for grade 1 and 2 hemorrhoids. Not recommended for external hemorrhoids, thrombosed hemorrhoids, or inflamed/necrotic internal hemorrhoids. A 1-2 ml sclerosant (commonly sodium tetradecyl sulfate, phenol 5%, quinine, urea hydrochloride, or polidocanol) is injected with a 25-gauge needle into the submucosal layer of the hemorrhoid.
Rubber Band Ligation:
A rubber band is placed around the hemorrhoid, causing ischemia, leading to sclerosis and eventual sloughing off. It is a simple, cost-effective procedure that can be done on an outpatient basis for grade 2 and 3 hemorrhoids.
Longo Method:
This method does not involve cutting the hemorrhoid but interrupts the blood supply to the upper and middle hemorrhoidal vessels. The pr*****ed re**al mucosa is then sutured back into place, reducing the hemorrhoid. The advantage is less discomfort since the a**l skin is not removed.
THD (Transa**l Hemorrhoidal Dearterialization):
This method uses ultrasound guidance to ligate the arteries supplying the hemorrhoids, thus reducing hemorrhoidal swelling.
Classical Hemorrhoidectomy:
Techniques like Milligan-Morgan, Ferguson, and Whitehead involve direct removal of the hemorrhoid. These methods are more invasive and can be painful.
