There
is another option to remove a hemorrhoid called Hemorrhoidal Artery Ligation
(HAL), also known as Transanal Hemorrhoidal Dearterialization (THD). In this
method, it locates the blood vessels causing the hemorrhoid using an ultrasound
and ligates, or closes off, those blood vessels. This is more effective than
rubber banding, but also has a higher cost and has longer-lasting pain result. This
is the first option if the first rubber banding fails depending on the type of
hemorrhoid.
Several
office-based procedures may be performed. It is a disclaimer that while
generally safe, rare serious side effects such as perianal sepsis may occur.
- Rubber Band Ligation is usually recommended as the first-line treatment in those with grade 1 to 3 disease. It is a procedure in which elastic bands are applied onto an internal hemorrhoid at least 1 cm above the dentate line to cut off its blood supply. Within 5–7 days, the withered hemorrhoid falls off. If the band is placed too close to the dentate line, intense pain results immediately afterwards. Cure rate has been found to be about 87% with a complication rate of up to 3%.
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| (Source: www.mayoclinic.org) |
- Sclerotherapy involves the injection of a sclerosing agent, such as phenol, into the hemorrhoid. This causes the vein walls to collapse and the hemorrhoids to shrivel up. The success rate four years after treatment is about 70%.
-
Several cauterization methods have been shown to be effective for hemorrhoids but are usually only used when other methods fail. This procedure can be done using electrocautery, infraredradiation, laser surgery, or cryosurgery. Infrared cauterization may be an option for grade 1 or 2 disease. In those with grade 3 or 4 disease, re-occurrence rates are high.
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