Sclerotherapy is a safe option for treating hemorrhoids.
Although mild hemorrhoids can be managed with home remedies, more severe and troublesome cases usually require treatment performed by a specialist. These treatments include:
- Laser coagulation
What is Sclerotherapy?
Sclerotherapy involves the injection of a chemical solution into the area around each hemorrhoid. The most commonly used chemicals include zinc chloride, quinine, and polidocanol. The intent of the procedure is to damage the blood vessels feeding the hemorrhoid, which causes it to shrink. The procedure is performed without anesthesia and only takes a few minutes. A proctoscope is inserted into the anus to allow the doctor to see the tissues and thus precisely target the injections. Most patients feel little to no discomfort during and after the procedure. Usually the injections need to be repeated several times at intervals of every few weeks to completely shrink the hemorrhoid. Unfortunately, the procedure may not be permanent and some patients experience a recurrence of the hemorrhoid two or three years later.
Who is a Candidate?
Doctors usually grade hemorrhoids on a scale of 1 to 4. Patients with troublesome hemorrhoids of grade 1 or 2 are candidates for sclerotherapy. Grade 1 hemorrhoids stay within the anal canal but may bleed frequently and be painful, while grade 2 may protrude beyond the anal canal during straining but return inside after straining stops; grade 2 may bleed frequently and be painful. Grade 3 protrudes outside the anal canal but can be manually pushed back in, while Grade 4 cannot be manually returned to the anal canal. Grades 3 and 4 generally require stapling or surgical treatment.
Safety of Sclerotherapy
In general, the procedure is considered to be extremely safe, even for patients with comorbidities like heart disease and diabetes. After each injection, patients may experience some mild bleeding and discomfort for a few days.
Grade 1 and 2 hemorrhoids can also be treated with ligation or laser treatment. During ligation, a tiny rubber band is placed around the base of the hemorrhoid to cut off its blood supply. Laser treatment uses a laser to coagulate the blood vessels feeding the hemorrhoid. Laser treatment, like sclerotherapy, is relatively painless and has few if any complications; however, laser treatment has a slightly higher rate of recurrence of hemorrhoids than sclerotherapy.