Effectivity of injection sclerotherapy with sodium tetra decyl sulphate in the management of first and second-degree hemorrhoids
DOI:
https://doi.org/10.18203/2349-2902.isj20180799Keywords:
Complication, Haemorrhoids, Rubber band ligation, Sclerotherapy, Sodium tetra decyl sulphateAbstract
Background: Haemorrhoids are one of the common surgical conditions affecting anorectal region with prevalence of 4% of the population. It is usually defined as increase in size as well as downward disruption of normal functional architecture known as anal cushions. Injection sclerotherapy is time honoured outpatient’s procedure that is widely practised globally to treat first and second-degree haemorrhoids.
Methods: This prospective study includes 52 patients who were underwent injection sclerotherapy at Bundelkhand Medical College and Associated Hospital Sagar from August 2015 to September 2016. Patients above the age of 18 years of both sexes with Ist and IInd degree hemorrhoids were included in the study. Pregnant patients, patients with diabetes mellitus and with third and fourth degree hemorrhoids were excluded from the study. A detailed history, clinical presentation, digital rectal examination, proctoscopy and routine investigation were done in all cases.
Results: In the present study most of the patients were male. Patients with age group ranging from 20-40 year were found of high incidence of haemorrhoids (86.53%). In present study after three doses of injection 94.23% had satisfactory result. After the first dose injection 71.15% patients had satisfactory results rest 15 patients were given second dose of injection of which 60% patients had satisfactory results. Third dose of injection given to the remaining 06 patients proved satisfactory results in only 03 cases. After three doses of injection 03 cases (5.76%) failed to show any response.
Conclusions: Sclerotherapy as a safe, easy, cheap and effective method of treatment of 1st and 2nd degree haemorrhoid devoid of any significant complication.
Metrics
References
RM Kirk. General Surgical Operations 4th Ed. London: Churchill Livingstone; 2000:353-358.
Acheson AG, Scholefield JH. Management of Haemorrhoids. BMJ. 2008;336(7640):380-3.
Russel RCG, William NS, Bulstrode CJK. Anus and Anal canal. Bailey and Love’s Short Practise of Surgery, 24th Ed. Arnold Publication; 2004:1242-63
Elnakeeb AM, Fikry AA, Omkar WH. Rubber Band ligation for 750 cases of symptomatic Haemorrhoids out of 2200 cases. World J Gastroenterol. 2008;14(42):6525-30.
Halverson A, MD Haemorrhoids. Clin Dis Colon Rectal Surg. 2007;20:17-85.
Sun WM, Read NW, Shorthouse AJ. Hypertensive anal cushion as a course of high anal canal pressure in patients with Haemorrhoids Br J Surg. 1990;77:458-62.
Gibbons CP, Bannister JJ, Read NW. Role of constipation and anal hypotonia in the pathogenesis of haemorrhoids. Br J Surg. 1998;75:656-60.
Loder PB, Kamm MA, Nicholls RS, Phillips RK. Haemorrhoids pathology, pathophysiology and etiology. Br J Surg. 1994;81;946-54.
Ramadan E, Vistrre T, Dreznik Z. Harmonic scalpel Haemorrhoidectomy: Preliminary results of a new alternate methods Tech Coloproctol. 2002;6;89-92.
Arbman G, Krook H. Closed vs. Open haemorrhoidectomy. Is there any difference?. Dis Colon Rectum. 2000;43(1):31-4.
Kubhchandani I, Paonessa N, Azimudink. Surgical Treatment of Haemorrhoids 2nd Ed. Springer; 2009:1-5.
Sneider EB, Maykel A. Diagnosis and management of symptomatic haemorrhoids. Surg Clin North Am. 2010;90(1)17-32.
Chauhan VF. Prospective comparative study of sclerotherapy by hypertonic and absolute alcohol for the treatment of haemorrhoids. Gujarat Med J. 2014;69(1);82-6.
Zinberg SS, Stern DH, Furman D. A personal experience in comparing three non-operative technique for treating internal haemorrhoids AMJ. Gastroenterol. 1989;84:488-92.
Ohinng GV, Machicado GA, Jensen DM. Definitive therapy for internal haemorrhoids New Opportunities and Options. Rev Gastroenterol Disord. 2009;9(1):16-26.
Khan RM, Itrat M, Ansari AH, Zulkifle M. A study on associated risk factors for haemorrhoids, J Biol Sci Opinion. 2015;3(1):36-8.
Bailey HR. Innovations for age old problem: Haemorrhoids in the female patient. Female Patient. 2004;29:17-23.
Johanson JF, Sonnenberg A. Constipation is not a risk factor for haemorrhoids: a case control study of potential etiological agents. Am J Gastroenterol. 1994;89:1981-6.
Rhee JC, Lee KT. The causes and management of lower GI bleeding: a study based on clinical observations at Hanyang University Hospital. Gastroenterol Japan. 1991;26:101-6.
Mann CV, Russel RCG, Williams NS. Bailey and Love’s Short Practice of Surgery. 22nd Ed. Arnold Publication; 1995:471-477.
Aigner F, Gruber H, Conard F. Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of haemorrhoidal diseases. Int J Colorectal Dis. 2009;24:105-13.
Izadpanah A, Hosseini SV. Comparison of electrotherapy, rubber band ligation and haemorrhoidectomy in the treatment of haemorrhoids: a clinical and manometric study. Middle East J Dig Dis. 2010;2:9-13.
Lohsiriwat V. Haemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol. 2012;18(17):2009-17.
Singh MP, Bhargava R, Ranwaka R. Prospective study on different modalities of treatment for symptomatic haemorrhoids. J Evolution Med Dent Sci. 2014;3(26):7127-31
Varma JS, Chung SC, Li AK. Prospective randomised comparison of current coagulation and injection sclerotherapy for the outpatient treatment of haemorrhoids. Int J Colorectal Dis. 1991;6(1):42-5.
Chugh A, Singh R, Agarwal PN. Management of haemorrhoids. Indian J Clinic Pract. 2014;25(6):577-80.
Quijano CE, Abalos E. Conservative management of symptomatic and complicated haemorrhoids in pregnancy and puerperium. Cochrane Database of Syst Rev. 2005;3:CD004077.
Mac-Rae HM, McLeod RS. Comparison of haemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rect. 1995;38(7):687-94.
Alatiso OL, Arigbabu OA, Lawal OO. Endoscopic haemorrhoidal sclerotherapy using 50% dextrose water: a preliminary report. Indian J Gastroenterol. 2009;28(1):31-2.
Johanson JF, Sonnenberg A. The prevalence of haemorrhoids and chronic constipation. An epidemiologic study. Gastroentrol. 1990;98(2):380-6.
Konsten J, Baeten CG. Haemorrhoidectomy Vs Lord’s method: 17 Year follow up of a prospective randomized trial. Dis Colon Rectum. 2000;43(4):503-6.
Al-Ghnaniem R, Leather AJ, Rennie JA. Survey of methods of treatment of haemorrhoids and complications of injection sclerotherapy. Ann R Coll Surg Engl. 2001;83(5):325-8.
Kaman L, Aggrawal S, Kumar R. Necrotizing fasciitis after injection sclerotherapy for haemorrhoids. Dis Colon Rectum. 1999;42(3):419-20.
Barwell J, Watkins RM, Llyod-Davies E. Life threatening sepsis after haemorrhoidal injection sclerotherapy: report of a case. Dis Colon Rectum. 1999;42(3):421-3.
Bhuiya MFA, Rahman S, Ali A. Effectivity of injection sclerotherapy on early haemorrhoids reported to surgical outpatient department. JAFMC Bangladesh. 2010;6(2):25-7.