Hemorrhoids Sclerosing Treatment
It is recommended only for internal hemorrhoids in stage 1. It is contraindicated in externalized internal hemorrhoids and external hemorrhoids because it causes pain, important bedsores and long-term inflammatory responses.
It is also contraindicated to practice sclerosing injections in the acute inflammatory hemorrhoidal phase or in the presence of nearby septic processes (abscesses, fistulas). Pregnancy and bleeding diatheses are formal contraindications.
Instead, anal itching benefits of sclerosing treatment.
Sclerosing injections are done in the upper part of the hemorrhoids. Some surgeons are doing intrahemoroidal injection, this method is painful, so it is becoming less common.
Preparing the patient. It is not recommended a purgative before making the injection. If the part where the injection will be done is covered with feces, this part will be cleaned with the mounted pad.
Position of the patient. The most comfortable position for the patient is the knee-chest position.
The anoscope will be introduced slowly and gradually, beating the hemorrhoid. Rectal mucosa appears, pale pink. The existence of inflammatory lesions contraindicate sclerosing therapy.
Sclerosing treatment is repeated if necessary, one week period, not exceeding 8-12 injections. After injection we recommend a half hour rest.
Incidents and accidents. Are not very serious and can be avoided through a rigorous technique and indication.
Immediate pain means that the sclerosing substance entered in muscle or mucous layers.
Immediate or late bleeding is due to necrosis.
Abscesses or bedsores are met when it was practiced sclerosing injections in full inflammatory flare. Therefore, we will treat the rectitis first and then will move to the sclerosing treatment of hemorrhoids. Eschar is due to technical mistakes, when the injection was made either too superficial (mucosa) or too deep (muscle).
Tenesmus (urge to defecate), rectal and bladder disorders such as pain, dysuria (difficult urination), hematuria (blood in urine) are transient.
Hemorrhoidal phlebitis can sometimes occur.
Quinine intolerance is manifested by headache, rash, malaise. In these cases it will be replaced with solution of 5% moru sodium.