HEMORRHOID DISEASE: DIAGNOSIS TREATMENT AND COMPLICATION MANAGEMENT

Hemorrhoidal_Disease_Bahadir_Egekapak

OFFICE BASE TREATMENT OF HEMORRHOIDAL DISEASE

Merter Gülen

Atılım University, Faculty of Medicine, Department of General Surgery, Ankara, Türkiye

Gülen M. Office Base Treatment of Hemorrhoidal Disease. In: Ege B, editor. Hemorrhoidal Disease: Diagnosis, Treatment and Complication Management. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.73-78.

ABSTRACT

Hemorrhoidal disease is a prevalent condition marked by the symptomatic prolapse of vascular structures within the anal canal. Office-based procedures offer effective and minimally invasive treatment alternatives for patients with symptomatic grade I and II hemorrhoidal disease, as well as for certain patients with grade III hemorrhoidal disease that do not respond to conservative treatments. The most commonly employed office-based treatment techniques include rubber band ligation, injection sclerotherapy, and infrared coagulation. These procedures aim to correct hemorrhoidal prolapse, re-fix the tissue to the underlying structures, reduce vascularity, and eliminate redundant tissue. Rubber band ligation is widely used due to its efficacy, simplicity, and relatively low complication rates. Injection sclerotherapy, which involves the injection of sclerosing agents into the submucosa, is an effective and frequently preferred alternative. It is particularly suitable for patients with hemorrhoids complicated by bleeding, offering lower post-procedural pain and reduced complication risks. Infrared coagulation, although less effective than rubber band ligation, is typically linked to reduced post-procedural pain and complications, though it may require additional treatment sessions. The selection of treatment should consider individual factors such as the severity of hemorrhoidal disease, underlying comorbidities, and patient preferences. The American Society of Colon and Rectal Surgeons strongly endorses these office-based procedures for managing grade I and II hemorrhoidal disease and select grade III cases. In conclusion, office-based treatments offer safe and effective alternatives for managing hemorrhoidal disease, improving patient quality of life, and reducing the need for surgical interventions.

Keywords: Hemorrhoids; Sclerotherapy; ligation; Office management; Bleeding

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