Colorectal Surgery Clinic

Treatment options

Grading of the

internal hemorrhoids

Treatment

Outcomes

Length of hospital stay

Medications

Grade 1 or 2

• Taking stool softeners or laxatives, anti-inflammatory medication.

• Topical cream, ointment or suppository to relieve pain, itchiness as well as to reduce the inflammation.

• For severe pain, the combination of pain pills and 15-minute-warm sitz bath 2-3 times daily may be helpful.

• Suppository is recommended for 7-10 days.

• If not better, medical attention is required.

–

Injection (Sclerotherapy)

Grade 2

• The sclerosant is injected to shrink hemorrhoid.

• Repeated injection may be required.

• Out-patient procedure.

• Minimal discomfort.

–

Rubber Band Ligation

              Grade 1-3

• Tiny bands placed to cut off the circulation. The hemorrhoid will fall off within 5-7 days.

• Out-patient procedure.

• Minimal discomfort.

•  Effective

–

       Laser Hemorrhoidoplasty

Grade 2-4

• Laser applied to the hemorrhoid vessels, to shrink the hemorrhoid.

• Widely accepted.

• Minimal pain.

• Rapid recovery.

2 nights

Radiofrequency Coagulation

Grade 2-4

• Considered a non-surgical approach, hemorrhoid is directly coagulated by special form of energy called radiofrequency, facilitating the immediate disappearance of the hemorrhoid.

• Widely accepted.

• Minimal pain.

• Rapid recovery.

• Out-patient procedure.

 Day surgery

Hemorrhoidectomy

Grade 3-4

• The hemorrhoid removed surgically.

• Effective.

• Less recurrence.

Day surgery or

2 nights stay

     Stapled Hemorrhoidopexy

Circumferential grade 3-4

• The stapler (a disposable instrument with a circular stapling device at the end) is used to block blood flow to hemorrhoid and repositioning of the hemorrhoid.

• Minimal pain.

• Rapid recovery.

 2 nights

 Transanal Hemorrhoidal Dearterialization (THD)

Circumferential grade 3-4

• THD is a minimally invasive technique using a specially anoscope with Doppler transducer to identify the hemorrhoid arteries. Once the hemorrhoid arteries are detected, a suture ligation is conducted in order to limit the blood flow to the hemorrhoids. The rectopexy then performed and repositioning of the hemorrhoid.

• No incision/cut.

• Minimal pain.

• Rapid recovery.

1 nights