There are a variety of treatment options available to deal with hemorrhoids, including rubber band ligation, scierotherapy, hemorrhoidectomy, transanal hemorrhoidal dearterialization (THD), thrombosed hemorrhoid treatment, and hemorrhoidal prolapse. To discuss the best treatment option for your individual situation, please make an appointment with Dr. Nasseri or Dr. Barnajian at the Surgery Group of Los Angeles.
Rubber Band Ligation
Rubber band ligation is typically recommended as the first-line treatment in those with grade 1 to 3 disease. It is a procedure in which elastic bands are applied onto an internal hemorrhoid at least 1 cm above the dentate line to cut off its blood supply. Typically, within 5–7 days, the withered hemorrhoid falls off.
Sclerotherapy might be considered as a treatment for grade 1 or grade 2 hemorrhoids. In this procedure, a proctoscope is gently inserted into the anus. A proctoscope is a short tube with a light on it which the doctor can use to look at the membranes lining the anus. With the help of the proctoscope, a liquid containing drugs such as quinine, polidocanol or zinc chloride is then injected into the area around the enlarged hemorrhoids. The aim of this procedure is to shrink the hemorrhoids by damaging blood vessels and reducing the blood supply to the hemorrhoids.
Hemorrhoidectomy is surgery to remove hemorrhoids. You will be given general anesthesia or spinal anesthesia so that you will not feel pain. Incisions are made in the tissue around the hemorrhoid. The swollen vein inside the hemorrhoid is tied off to prevent bleeding, and the hemorrhoid is removed.
Transanal hemorrhoidal dearterialization (THD) is a minimally invasive surgical procedure for the treatment of internal hemorrhoids. This procedure in done minimally -invasive and can be completed in one of our state-of-the-art out patient facilities. Use Doppler Technology to locate the terminating branches of the hemorrhoidal arteries, the surgeon uses an absorbable suture to ligate or “tie-off” the arterial blood flow.
This procedure offers patients a similar result with significantly less pain, and a quicker recovery than traditional hemorrhoid removal treatments.
Thrombosed Hemorrhoid Treatment
Thrombosed hemorrhoid sometimes occurs when blood pools in an external hemorrhoid and form a clot (thrombus) that can result in severe pain, swelling, inflammation and a hard lump near your anus.
Although conservative nonsurgical treatment (stool softeners, increased dietary fiber, increased fluid intake, warm baths, analgesia) ultimately results in improvement of symptoms for most patients, surgical excision of the thrombosed external hemorrhoid often precipitates resolution.
Severe cases of hemorrhoidal prolapse will normally require surgery.
Newer surgical procedures include stapled transanal rectal resection (STARR) and procedure for prolapse and hemorrhoids (PPH). Both STARR and PPH are contraindicated in persons with either enterocele or anismus.