AND HEMORRHOIDS ARE ONLY THE TIP OF THE ICEBERG

Hemorrhoids and the evolution of the human being  and defecation posture |  Hemorrhoids The underlying

mechanisim  |Hemorrhoids Diverticulosis coli | Hemorrhoids Hiatus hernia | Hemorrhoids Cardiovascular

events at defecation | Instructions |  Hemorrhoids Video of a new squatting device | Hemorrhoids Bran diet

hypothesis isn't relevant | Hemorrhoids 150 years to sitting toilet bowl |Squatting for the Prevention of Hemorrhoids  The Prevalence of hemorrhoids  |

Treatment of hemorrhoids (rubber band ligation)

This procedure is most suitable for prolapsing hemorrhoids, the second-degree hemorrhoids. The 

principle of the method is to apply a rubber ring ligature to the mucosal-covered part of the internal hemorrhoid.The application of rubber ring on the hemorrhoid is done through a proctoscop Over period of seven to ten days the elastic band gradually cats the tissues and the hemorrhoid sloughs off spontaneously Some recomend that only one hemorrhoid should be dealt with at a time, and that further ligations in the hemorrhoids should be carried out at intervals of three weeks or so,as required(1).The principle is to continue treatment sessions on a monthly basis until patients are symptom free.

The majority pf patients require two or three sessions Others found easy to deal with two or three hemorrhoids at the same session(2). Steinberg et al found that after rubber band ligation the majority of patients
considered themselves cured or greatly improved by the treatment(3).  However, only 44 percent were completely symptom free. Intermittent mild discomfort, occasional spotting of blood and

an awareness of lumps at the anus were the principal residual symptoms.
patients. 12 patients in Steinberg et all. group had either a further rubber
band ligation, an anal dilatation or a lateral sphincterotomy.
One patient requiered a hemorrhoidectomy due to failure of the technique to
control symptoms.

The authors think that rubber band ligation is a moderately
effective method of treating symptoms due to hemorrhoids 

 with undoubted economic advantages over a conventional hemorrhoidectomy.

F. Greca et al compared rubber band ligation with injection for treatment of hemorrhoids (4

Eighty-nine consecutive patients with symptomatic hemorrhoids were included in the study
Patients were allocated by a series of random numbers to receive treatment by injection
or rubber band ligation after prior sigmoidoscopy had confimed that there was no other additional pathology.
No attempt was made to ligate more than two sites at the first attendance.
It was explained to patients that a second application of rubber bands to any residual hemorrhoids might be necessary 

Phenol injection was with 2-3 ml of 5 percent solution in almond oil injected into the mucosa
just above the three primary hemorrhoids.
The authors conclude  that the symptomatic results of rubber band ligation  do not differ from injection.
However rubber band ligation was associated with a higher incidence of complications
and three of them required
hospital admission,two for anal dilatation and one for a blood transfusion.
No such complications attended phenol injection.
The authors noted that the control of prolapse appears to have increase with time
;however, in these patients repeated treatment
by injection or band ligation was undertaken at the follow-up.
The authors found low incidence of complications with injection, and supposed that injection is the treatment of vhoice for patients with 

first and second degree hemorrhoids. Many of these patients in this group were needed repeated injections

Read more on this topics

      Doppler guided ligation

      Doppler guided ligation

      Ligation under vision

Notes: great majority of people of Western World may prevent the problem of hemorrhoids by switching to natural
for the human being squatting defecation posture.

Read more on this topic on this site:
Hemorrhoids are the consequence ...

Only 3-5 percent of population may suffer from hemorrhoids inspite of practicing squatting defecation posture,
this is explained by an inhereted immobile recto-anal anatomical structure. Patient with morbid
obesity may found
the sitting defecation posture more convenient and accordingly
are candidates to suffer from hemorrhoids and allied problems.

References:

1 Barron J. Office ligation of internal hemorrhoids Am. J. Surg. 105,563,1963

2 Bartizal J. et all An alternative to hemorrhoidectomy Arch Surg.Chicago, 112, 534, 1977

3 Steinberg D et all Long term review of the results of rubber band ligation of

hemorrhoids. Br J. Surg. 62,144-146,1975

4 Greca. F. A randomized trial to compare rubber band ligation with phenol injection

for treatment of hemorrhoids. Br.J Surg. 68, 250-252,1981