History of hemorrhoids research it is a history of great mistakes

                                                                                                                                             

treatment of haemorrhoids(injection sclerotherapy) 

When simple medical treatment of hemorrhoids such as diet , ointments, suppositories ,high fiber diet have failed to control symptoms,more aggressive treatment is indicated,with the objectives of preventing bleeding and mucosal prolapse through the anus,correcting anal outlet stenosis or spasm,and removing rebundant or hypertrofied tissues.Mucosal prolapse can be prevented by fixing the mucosa overlying the vascular cushions to the underlying muscular wall of the bowel-a result achieved by sclerosant injections.Originally the injections is done into  substance of the haemorrhoid which is phenol in arachis oil. It now injected mostly into the submucous space above each of the three principal haemorrhoids.The injection works by producing submucosal fibrosis and so fixing the mucosa to the underlying muscle.The injection may cause severe pain if it is too close to the anal verge.Injection sclerotherapy has proved quite effective in patients whose only symptom is bleeding and whose pile do not prolapse.Injection is less effective for prolapsing haemorrhods.The results of sclerosant therapy are gratifying to the patient,as bleeding  usually cease immediately.However , the the clinician may often be puzzled by the absence of any change in the appearance of the piles at subsequent endoscopy,despite amelioration of symptoms.It is the exception rather than the rule to find palpabele injection nodules at the siteof injection on rectal examination after an interval of several weeks.Submucosa injection of oill results in globules of varying size surrounded by histocytes and giant cells. Tissue fluid will presumably be present on the surface of the histocytes, dividing them from the oil globules.

It is recognized by most that much of the oill is extruded from the submucous space almost immediately following the injection.

The curative effects of injection do not dependent upon any specific action of the chemical substance, it is the secondary changes, in particularl the intravascular clotting, and subsequent fibrosis, to which any beneficial effect must be ascribed.

Read more about injection sclerotherapy .*

PS. One of my first patients was a strong man which has undergone an injection sclerotherapy for bleeding.The bleeding has stopped but he suffered from strong pain for as one year.This patient visited many rectal surgeons but nobody could help him. He told that he afraid to go to the toilet room, and began to eat lesser in order to avoid the defecation act. Two weeks following my instruction to change the sitting to squatting defecation posture a happy telephone voice of this patient informed me that the pain stopped completely.