Hemorrhoid Injection Procedure: A Comprehensive Patient Guide

Introduction and Terminology of the Procedure

If you are experiencing hemorrhoids, you’re not alone. Millions of adults in the USA are affected by this common but often uncomfortable condition. Hemorrhoids, or swollen veins in the lower part of the rectum and anus, can be treated in various ways. One effective method is Hemorrhoid Injection, also known as Sclerotherapy. This treatment involves injecting a chemical solution directly into the hemorrhoid, causing it to shrink and eventually disappear.

Sclerotherapy is a widely-used treatment for hemorrhoids. According to the American Society of Colon and Rectal Surgeons, about 50% of adults in the USA experience hemorrhoid symptoms by the age of 50, and a significant number of these individuals opt for this non-surgical procedure.

Indications for Hemorrhoid Injection

Hemorrhoid Injection or Sclerotherapy is generally recommended for the following situations:

• Internal Hemorrhoids: This procedure is specifically designed for internal hemorrhoids, particularly those that bleed.
• Non-responsive to conservative treatments: When dietary changes, topical ointments, or other non-invasive treatments don’t alleviate hemorrhoid symptoms.
• Painful Hemorrhoids: In instances where hemorrhoids cause significant discomfort or pain.
• Recurrent Hemorrhoids: If hemorrhoids keep coming back despite other treatments.
• Grade I and II Hemorrhoids: Hemorrhoid Injection is typically suitable for grade I and II hemorrhoids (small to moderate size).

As with any medical procedure, it is important to discuss with your doctor whether Hemorrhoid Injection is the best treatment for your specific circumstances. Factors such as your overall health, age, and the severity and type of your hemorrhoids will all play a role in determining the most effective treatment.

Pre-Op Preparation

Before undergoing a Hemorrhoid Injection, there are several steps to prepare:

• Fasting: Your doctor may advise you to fast for a certain period before the procedure.
• Medication adjustments: Some medications may need to be stopped or adjusted. It is crucial to inform your doctor about all the medicines you are currently taking.
• Pre-op labs or imaging: Certain tests may be necessary to evaluate your overall health before the procedure.
• Pre-clearance authorization: Ensure that the procedure has been authorized by your insurance provider.
• Transportation and work/school notes: You may need to arrange for someone to drive you home after the procedure, and you may require a note for your work or school.

Please note that these instructions are general guidelines and your doctor may provide you with specific instructions based on your personal health condition. Our telemedicine primary care practice is equipped to provide pre-operative clearances and can assist with ordering any required pre-op labs or imaging.

Always consult your doctor about the exact pre-op preparations, including any medications to be stopped before the procedure, and when they should be resumed after the procedure. It is important to follow these instructions closely to ensure the best outcome from your Hemorrhoid Injection.

Procedure Technique for Hemorrhoid Injection

Understanding the step-by-step process of the Hemorrhoid Injection procedure can alleviate some of the anxiety you may be feeling. Let’s walk through what your doctor will be doing during this treatment, explained in simple terms.

1. Preparation

Upon arrival at the clinic, you’ll be led to a private room where you’ll be prepared for the procedure. You will be asked to change into a hospital gown and positioned comfortably on an examination table, typically lying on your side or with your knees drawn to your chest. This position provides the doctor with the best access to the hemorrhoids.

2. Anesthesia

In most cases, Hemorrhoid Injection doesn’t require general anesthesia. You’ll be awake but should feel minimal discomfort. A local anesthetic may be used to numb the area around the hemorrhoids, ensuring you are comfortable throughout the procedure.

3. Initial Examination

The doctor will conduct an initial examination using a device called an anoscope. This is a small tube that allows your doctor to see the hemorrhoids clearly. The anoscope will be gently inserted into your rectum after applying a lubricant for a smoother entry.

4. Injection Process

Once the doctor has a clear view of the hemorrhoids, the injection process begins. Using a fine needle, a chemical solution will be directly injected into the hemorrhoid tissue. This solution works to harden the hemorrhoid, causing it to shrink.

You may feel a brief pinch or a burning sensation during the injection, but the discomfort is typically minimal. If you feel too uncomfortable, let your doctor know so adjustments can be made.

5. Post-Procedure

After the injection, the anoscope will be gently removed. The whole process typically takes about 15 to 30 minutes, depending on the number and size of the hemorrhoids being treated.

Once the procedure is completed, you’ll be given a brief period to rest and recover before being allowed to dress and prepare to leave the clinic. It’s normal to feel some mild discomfort or pressure in the rectal area after the procedure. However, severe or worsening pain should be reported to your doctor immediately.

Remember, everyone’s experience with Hemorrhoid Injection can vary slightly depending on their specific situation, including the severity of the hemorrhoids and their body’s response to the procedure. Always feel free to ask your doctor or healthcare provider any questions you may have. They are there to provide you with the information and reassurance you need.

Duration of Hemorrhoid Injection

The Hemorrhoid Injection procedure is relatively quick. It typically takes about 15 to 30 minutes to complete, depending on the number and size of hemorrhoids being treated.

Post-Op Recovery from Hemorrhoid Injection

After the procedure, you’ll likely be able to return home the same day. You may feel some mild discomfort or pressure in the rectal area, but this should lessen over time. It’s normal to have some mild bleeding for a few days following the procedure.

Typically, a follow-up appointment will be scheduled within two weeks to monitor your progress. No specific physical therapy or rehabilitation is usually necessary. However, your doctor may recommend dietary changes, such as increasing fiber and water intake, to prevent constipation and reduce strain on the hemorrhoids.

As for lifestyle changes, you may need to avoid strenuous activity and heavy lifting for a week or so. Most people can return to work within a day or two, but it may vary depending on the nature of your job and your personal comfort. Remember that our practice offers same-day appointments until 9 pm on weekdays and 5 pm on weekends to provide work or school notes if necessary.

Full recovery usually takes a couple of weeks, but it can differ from person to person. It’s important to keep your follow-up appointments and contact your doctor if you notice any complications.

Effectiveness of Hemorrhoid Injection

Hemorrhoid Injection or Sclerotherapy is a highly effective treatment for hemorrhoids, particularly for bleeding internal hemorrhoids. Statistics from the American Society of Colon and Rectal Surgeons show that sclerotherapy successfully treats hemorrhoids in about 60-80% of cases.

However, the procedure’s effectiveness can be influenced by several factors. First, the severity and grade of the hemorrhoids can impact the treatment’s success. Sclerotherapy is most effective for smaller, grade I and II hemorrhoids. Larger, more severe hemorrhoids may require other treatments or a combination of procedures.

Second, lifestyle factors can impact effectiveness. A diet high in fiber and sufficient hydration can help prevent the recurrence of hemorrhoids, increasing the treatment’s long-term effectiveness. Regular exercise and avoiding prolonged sitting can also help.

However, there are also situations that can lower the effectiveness. For instance, straining during bowel movements, constipation, and chronic diarrhea can worsen hemorrhoids and decrease the effectiveness of the treatment. Additionally, patients with certain underlying health conditions, such as liver cirrhosis or cardiovascular diseases, may have a lower success rate.

In conclusion, Hemorrhoid Injection is a generally effective and safe procedure for treating hemorrhoids. However, its success depends on various factors, including the severity of the hemorrhoids, the patient’s overall health, and post-procedure care and lifestyle adjustments.

Adverse Events with Hemorrhoid Injection

While Hemorrhoid Injection is generally a safe procedure, like all medical treatments, it comes with potential risks and side effects. Here are some of the possible adverse events:

• Pain or discomfort (5-10%): You may feel mild to moderate pain or discomfort, particularly when passing stools. This usually resolves within a few days.
• Bleeding (2-5%): Minor bleeding may occur after the procedure, especially during bowel movements. If heavy or prolonged bleeding occurs, contact your healthcare provider immediately.
• Infection (<1%): Although rare, infection at the injection site can occur. Symptoms may include fever, increasing pain, and pus discharge.
• Anal stricture (1-2%): In some cases, repeated treatments can lead to narrowing of the anal canal, known as anal stricture. This could make bowel movements difficult.

The mortality rate from Hemorrhoid Injection is extremely low, with no direct deaths reported in the literature due to the procedure itself. However, any signs of severe complications should be reported to your healthcare provider immediately.

Alternatives to Hemorrhoid Injection

While Hemorrhoid Injection is an effective treatment for hemorrhoids, several alternatives are also available. Other non-surgical options include rubber band ligation, where a band is placed around the base of the hemorrhoid to cut off its blood supply, and infrared coagulation, which uses heat to shrink the hemorrhoid. Surgical options include hemorrhoidectomy (removal of the hemorrhoid) and stapled hemorrhoidopexy, where the hemorrhoids are lifted and stapled back into place.

Medications such as over-the-counter creams and suppositories can also help with symptoms. Lifestyle changes, such as increasing dietary fiber and fluids, regular exercise, and avoiding straining during bowel movements, can prevent the formation or worsening of hemorrhoids.

Experimental or Emerging Technologies

New treatments for hemorrhoids are continually being explored. One promising technology is Doppler-guided hemorrhoidal artery ligation, which uses ultrasound to locate the hemorrhoidal arteries so they can be tied off, reducing blood flow to the hemorrhoids. Early studies suggest this procedure may be effective and cause fewer complications than traditional methods.

Conclusion

In conclusion, Hemorrhoid Injection is an effective, minimally invasive treatment for hemorrhoids. While it does carry some risk of adverse events, these are generally mild and infrequent. Several alternatives exist for patients seeking different treatment approaches. As with any medical procedure, it’s essential to discuss all options, potential risks, and benefits with your healthcare provider to make an informed decision about your care.

Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.