Overview
Injection sclerotherapy is a medical procedure used to treat small internal hemorrhoids. This fixative procedure uses a chemical that scars the tissues and cuts off the hemorrhoids' blood supply.
The doctor injects the chemical into the vein within a hemorrhoid. The chemical causes the vein to harden and the hemorrhoid tissue to die. A scar forms in place of the hemorrhoid on the wall of the anal canal. The scar tissue, which is firm and thick, holds nearby tissue and veins in place so they don't bulge into the anal canal.
What To Expect After Treatment ?
Bleeding from the anus occurs 7 to 10 days after the procedure, when the hemorrhoid falls off. Bleeding is usually slight and stops by itself.
- You may use mild pain relievers and sit in a shallow tub of warm water (sitz bath) for 15 minutes at a time to relieve discomfort.
- To reduce the risk of bleeding, avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs) for 4 to 5 days both before and after injection sclerotherapy.
- Health professionals recommend that you take stool softeners containing fiber to ensure smooth bowel movements. Straining during bowel movements can cause hemorrhoids to recur.
Why It Is Done ?
Doctors recommend injection sclerotherapy in cases where :
- Small hemorrhoids do not improve with home treatment.
- Internal hemorrhoids are too small to treat with rubber band ligation.
- You have persistent bleeding from hemorrhoids.
- You are older than age 70 or are in poor health and would not be a candidate for more invasive surgery.
How Effective Is The Procedure ?
Injection treatment for hemorrhoids with sterile solution is indeed very effective, but it takes some time for the patient to recover completely. Approximately after 7 days from the procedure, the anus starts bleeding as the hemorrhoid actually falls off. Nonetheless, the bleeding isn’t heavy and it usually stops on its own.
After the treatment you might need to take some pain relievers, usually milder ones, to relieve yourself from the discomfort. Sitz bath also helps.
To prevent bleeding, you must not take any drugs, particularly nonsteroidal anti-inflammatory drugs or NSAIDs for at least a week.
After the injection therapy, you must take stool softeners. It is usually recommended by doctors so as to avoid straining and hard stools that might lead to reoccurrence of the hemorrhoids.
How Well It Works ?
For small hemorrhoids, injection sclerotherapy relieves symptoms about as well as rubber band ligation. However, sclerotherapy does not work as well as ligation for large hemorrhoids. Hemorrhoids often recur after injection sclerotherapy. Treatments can be repeated.
Risks
Rare complications include:
- Painful burning if the injection is given too close to the anus, where pain-sensitive nerve endings are located.
- Allergic reaction to the injected chemical.
- Shedding of the rectal lining (mucosa), leaving an open wound (ulcer).
- Infection of the anal area.
- Inability to control bowels or bladder (incontinence).
- Infection of the prostate gland (prostatitis) in men.
- Bleeding.
Complications
Some rare complications have been reported when treated with injection.
If not injected properly, painful burning sensation might occur in the affected region. Allergic reactions have also been observed in some cases. Rare cases of ulcer and mucosa have also been reported. In some worst cases infections tend to occur on the anal region.
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