Lalit V. Tamgadge1 , Nilesh P. Mangam2 , Ashok Gajbhiye3
BACKGROUND Haemorrhoids are one of the common causes of rectal bleeding associated with pain and discomfort. They are one of the common causes of surgical consultations. Surgical treatment such as haemorrhoidectomy is usually reserved for grade III and IV haemorrhoids and is associated with complications such as post-operative bleeding, faecal impaction, urinary retention, constipation and infections. Sclerotherapy for haemorrhoids is a less-invasive, less-painful procedure that causes the problematic haemorrhoid to shrivel and dissipate within a short period of time. Many studies have concluded that injection sclerotherapy when properly used, is efficient, inexpensive and safe method for the treatment of bleeding haemorrhoids. We conducted this study to evaluate the effectiveness of sclerotherapy as a treatment modality for internal haemorrhoids of grade I and II. METHODS This was a prospective study conducted in the department of general surgery in a tertiary care institute located in a tribal area. 100 cases of Grade I and Grade II internal haemorrhoids were included in this study on the basis of predefined inclusion and exclusion criteria. Detailed history was taken, and a thorough clinical examination was done in all the cases. Sclerosant (Polidocanol 3 - 5 mL) solution was injected into the submucosal tissue of the base of an internal hemorrhoid using aseptic precautions. Postoperatively patients were followed up to 6 months for resolution of symptoms. RESULTS Out of the 100 studied cases there were 85 (85%) males and 15 (15%) females with a M : F ratio of 1 : 017. The overall mean age of the affected cases was found to be 44.98 years. 71% of cases had history of constipation and straining at stools. The most common presenting complaint was bleeding which was seen in 67 (67%) cases. After sclerotherapy, discomfort was reported in 20 (20%) patients whereas pain and bleeding were seen in 12 (12%) and 7 (7%) patients respectively. At 6 months follow up there was no patient with pain, prolapse, irritation or discharge (100% improvement in these symptoms). Bleeding was seen in 3 patients (3%) at 6 months follow up. CONCLUSIONS Injection sclerotherapy is an effective treatment modality for the treatment of grade I and II haemorrhoids. It was found to have excellent results in terms of resolution of symptoms such as bleeding, pain, irritation, discharge and prolapse.
