Selected treatment options entirely depend on presenting symptoms and disease severity as well as individual conditions of the patients. Treatment options include:
1) Non-surgical approach consists of
Rectal suppositories or ointments
Injection (sclerotherapy). A chemical solution is injected into the hemorrhoid tissue in order to shrink it by damaging blood vessels and reducing the blood supply to the hemorrhoids. The interval for injection is very 2-4 weeks.
Rubber band ligation. During procedure, one or two tiny rubber bands are placed around the base of an internal hemorrhoid to cut off its circulation. The hemorrhoid withers and falls off within a week.
Hemorrhoid banding can be uncomfortable and cause bleeding, therefore it should be performed by highly experienced specialists in order to reduce risks of serious complications.
2) Surgical approach
If other procedures have not been successful or patients have large hemorrhoids that cannot be pushed in place, surgery is highly recommended. Types of surgery is determined by sizes and types of hemorrhoids as well as locations. Surgical options are:
Open hemorrhoidectomy: An open hemorrhoidectomy is surgery to remove internal or external hemorrhoids that are extensive, large or severe.
Stapled hemorrhoidectomy: Stapled hemorrhoidectomy is mostly used in patients with extensive hemorrhoids. During stapled hemorrhoidectomy, a circular stapling device is used to excise a circumferential ring of excess hemorrhoid tissue, thereby lifting hemorrhoids back to their normal position within the anal canal. Stapling also disrupts hemorrhoid blood supply. Studies have suggested that stapled hemorrhoidectomy results in less post-operative pain and shorter recovery compared with conventional surgery.
Laser hemorrhoidectomy: Hemorrhoid laser procedure is a new laser procedure for treatment of hemorrhoids in which hemorrhoidal blood flow feeding the hemorrhoidal plexus is stopped by laser coagulation. It is recommended in hemorrhoids with mild stage while the size is still small. This procedure causes less pain, faster recovery time and fewer post-operative complications or side effects.
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