Haemorrhoid treatment (1)

• Varies from simple reassurance to surgery
• Treat symptomatic disease only
• Depends on grading

It is divided into four categories:

1. Dietary and lifestyle modification to prevent hemorrhoids formation
2. Medications to relieve symptoms
3. Outpatient hemorrhoid treatment
4. Operation

Treatment is according to severity of hemorrhoids

	Dietary and lifestyle modifications	Medications	Outpatient procedures	Operations
Grade 1	✓	✓	+/-	x
Grade 2	✓	✓	✓	+/-
Grade 3	x	x	✓	✓
Grade 4	x	x	x	✓

 

Dietary and lifestyle modification

The goal is to minimize straining at stool by minimizing constipation. Increase fluid intake which acts as stool softeners is encouraged in diet. Moreover, regular defecatory habits should be developed.
 


 Medications

There are two kinds of medications, local and oral medications. This helps to:

• arrest bleeding
• relieve pain, irritation, and inflammation
• guard against infection

 

Outpatient hemorrhoid treatment

• Rubber band ligation, endoscopic ligation
• Sclerotherapy
• Infrared coagulation
• Bicap electrocoagulation
• Cryotherapy
• Laser treatment

 

Banding / Ligation of hemorrhoids

It is carried out for Grade 2 and 3 internal hemorrhoids. The principle of it is to cause ischemic necrosis by banding, which will slough off within a few days. 60-70% successful response rate is found when cured with a single treatment session

Video Demonstration

 

Reference: psclinic.com.hk/

The information aims to provide educational purpose only. 

Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

 

Hemorrhoid treatment (2)

Traditional surgery – Hemorrhoidectomy 

 Principles
- Decrease the blood flow to anorectal ring
- Remove redundant hemorrhoidal tissue


 Indications
- Grade II, III and IV hemorrhoids
- Failure of non-operative treatment of 2nd degree pile
- Thrombosed hemorrhoid 
- Interoexternal pile when the external pile is well defined


 Types
- Excision of hemorrhoids without (open hemorrhoidectomy) or with (closed hemorrhoidectomy) suturing 
- Using different energies for excision
 Diathermy
 Harmonic scalpel
 Bipolar scissors









Reference: psclinic.com.hk/

The information aims to provide educational purpose only. Anyone reading it should consult 
Surgery Specialist before considering treatment and should not rely on the information

above.

Hemorrhoid treatment (1)

Dietary and lifestyle modifications
 Goal: to minimize straining at stool  minimizing constipation
 Diet
- Increase fluid intake
- Stool softeners
 Lifestyle modifications
- Regular defecatory habits


Medications
 Local and oral medications
 Arrests bleeding
 Relieves pain, irritation, and inflammation
 Guard against infection


Outpatient hemorrhoid treatment
 Rubber band ligation, endoscopic ligation
 Ultroid system
 Sclerotherapy
 Infrared coagulation
 Bicap electrocoagulation
 Cryotherapy
 Laser treatment


Banding / Ligation of hemorrhoids
 For Grade 2 and 3 internal hemorrhoids
 Principle: Banding  ischemic necrosis  slough off within few days
 Successful respond rate: 60-70% cured with a single treatment session

http://youtu.be/K7HKrBwuKSw (Video demonstration)




Reference: psclinic.com.hk/

The information aims to provide educational purpose only. Anyone reading it should consult

Surgery Specialist before considering treatment and should not rely on the information above.