scholarly journals Should we treat hemorrhoids according to the stage

2004 ◽  
Vol 51 (2) ◽  
pp. 77-79
Author(s):  
J. Pfeifer
Keyword(s):  
Internal Hemorrhoid ◽  
Rubber Band ◽  
Dentate Line ◽  
Hemorrhoidal Disease ◽  
Columnar Epithelium ◽  
Office Procedure ◽  
Internal Hemorrhoids ◽  
Bleeding Hemorrhoids

Hemorrhoidal disease is a very common and widespread disease, and it is estimated that about one subject out of three may suffer from this pathology. Hemorrhoids generally cause symptoms when enlarged, inflamed, thrombosed, or prolapsed. Internal hemorrhoids arise above the dentate line (in comparison to external hemorrhoids - perianal phlebothrombosis) and are covered by transitional or columnar epithelium. Scleotherapy is one of the oldest therapy forms mainly for bleeding hemorrhoids. The so called Barron ligature is an office procedure in which a small rubber band is placed at the base of the internal hemorrhoid with a special applicator.

scholarly journals RUBBER BAND LIGATION FOR HEMORRHOIDS (review)

2019 ◽  
Vol 18 (4) ◽  
pp. 151-160
Author(s):  
V. N. Ektov ◽  
К. A. Somov ◽  
A. V. Kurkin ◽  
V. A. Muzalkov
Keyword(s):  
Internal Hemorrhoid ◽  
Rubber Band Ligation ◽  
Rubber Band ◽  
Hemorrhoidal Disease ◽  
Band Ligation ◽  
Advantages And Disadvantages ◽  
Multi Stage ◽  
Outpatient Practice ◽  
Methods Of Treatment ◽  
Minimally Invasive Methods

Rubber band ligation is one of the most common and effective minimally invasive methods of treatment of chronic hemorrhoids. An analysis of the experience gained in the use of latex ligation makes it possible to evaluate the advantages and disadvantages of this technique and suggest new options for its implementation. One of the main advantages of rubber band ligation is the radicality of the procedure, which provides the closed removal of internal hemorrhoid piles, which makes it possible to standardize the widespread use of this technique in outpatient practice. When performing the procedure, tool kits of various designs are used, methods of one-stage and multi-stage ligation are used, various technical options are available for applying latex ligatures that affect the pathogenetic factors of hemorrhoidal disease. Optimization of options for the use of rubber band ligation allows to expand the range of use of this technique and provides a rational choice of individual approach.

scholarly journals Diagnosis and Management of Internal Hemorrhoids: A Brief Review

2021 ◽  
Vol 3 (5) ◽  
pp. 1-5
Author(s):  
Stephen William Soeseno ◽  
P. Agus Eka Wahyudi ◽  
Febyan Febyan
Keyword(s):  
Nutrition Education ◽  
Internal Hemorrhoid ◽  
Pathological Condition ◽  
Management Strategies ◽  
Outer Part ◽  
Proximal Part ◽  
Dentate Line ◽  
External Hemorrhoid ◽  
High Fiber ◽  
Internal Hemorrhoids

Hemorrhoidal disease is a pathological condition due to the abnormal engorgement of the arteriovenous plexus beneath the anal mucosa. Anatomically, it can be located under the skin on the outer part of the dentate line, known as external hemorrhoid; or inside the anus on the proximal part of the dentate line, called internal hemorrhoid. Internal hemorrhoid may further develop from a painless anal mass into protruded and painful mass throughout the anal canal, often accompanied by inflammation and more severe symptoms. Various management strategies need to be considered carefully to ensure the success of therapy and improve the quality of life of patients with internal hemorrhoids. Conservative management is the initial stage that can be performed, including the provision of high-fiber nutrition, education related to bathroom habits, and the use of flavonoid regimens. Surgical therapy can be divided into outpatient intervention and conventional surgeries. This review will encompass the comprehensive diagnostic approach and management of internal hemorrhoids to help clinicians understand the appropriate management and provide better clinical benefits for the patients.

Prospective Case Series of a Novel Minimally Invasive Bipolar Coagulation System in the Treatment of Grade I and II Internal Hemorrhoids

2016 ◽  
Vol 23 (6) ◽  
pp. 581-585 ◽  
Author(s):  
Benjamin P. Crawshaw ◽  
Andrew J. Russ ◽  
Bridget O. Ermlich ◽  
Conor P. Delaney ◽  
Bradley J. Champagne
Keyword(s):  
Minimally Invasive ◽  
Rubber Band Ligation ◽  
Case Series ◽  
Rubber Band ◽  
Dentate Line ◽  
Additional Treatment ◽  
Coagulation System ◽  
Recurrent Bleeding ◽  
Internal Hemorrhoids ◽  
Prospective Case Series

Background. Existing nonsurgical procedures for the treatment of grade I and II internal hemorrhoids are often painful, technically demanding, and often necessitate multiple applications. This study prospectively assessed the safety and efficacy of the HET Bipolar System, a novel minimally invasive device, in the treatment of symptomatic grade I and II internal hemorrhoids. Methods. Patients with symptomatic grade I or II internal hemorrhoids despite medical management underwent hemorrhoidal ligation with the HET Bipolar System. Endpoints included resolution or improvement of hemorrhoidal bleeding and/or prolapse from baseline, recurrent or refractory symptoms, and pain. Results. Twenty patients were treated with the HET Bipolar System. Two were lost to follow-up. Refractory or recurrent bleeding was present in 8 of 18 (44.4%), 4 of 11 (36.4%), and 4 of 8 (50.0%) patients, and prolapse was reported by 1 of 18 (5.6%), 4 of 11 (36.4%), and 1/7 (14.3%) of patients at 1, 3, and 6 months, respectively. Bleeding improved from baseline in 88.2%, 81.8%, and 87.5% of patients, and resolution of baseline prolapse was seen in 11 of 11 (100%), 4 of 7 (57.1%), and 5 of 5 (100%) patients at the same intervals. Thirteen of 18 (72.2%) patients did not require additional treatment for their symptoms. Conclusions. The HET Bipolar System is safe and easy to use with short-term effectiveness comparable to that of currently used techniques for the treatment of symptomatic grade I and II internal hemorrhoids. It may be an effective alternative to rubber band ligation in patients with larger internal hemorrhoids and those with hemorrhoids close to the dentate line in which banding may produce debilitating pain.

Do We Have Another Option to Treat Bleeding Hemorrhoids? The Emborrhoid Technique: Experience in 16 Patients

2020 ◽  
Vol 15 ◽  
Author(s):  
Elisabetta Moggia ◽  
Giuseppina Talamo ◽  
Gaetano Gallo ◽  
Gaetano Gallo ◽  
Matteo Barattini ◽  
...  
Keyword(s):  
Rectal Bleeding ◽  
Hemorrhoidal Disease ◽  
Severe Bleeding ◽  
Conventional Surgery ◽  
Short Term ◽  
Selective Embolization ◽  
Invasive Techniques ◽  
Bleeding Hemorrhoids

Background: Hemorrhoidal disease is very common in western countries and rectal bleeding is the main symptom complained by patients. Nowadays the ultimate goal of treatment is to block the bleeding with minimally-invasive techniques to minimize post-procedural pain. Objective: The aim of this study is to assess the preliminary results of the emborrhoid technique (embolization of the superior rectal arteries branches) as a new tool for the proctologist to treat severe bleeding hemorrhoids causing anemia. Many categories of patients might benefit from this treatment, such as patients not eligible for conventional surgery, patients not responding to conventional treatment and fit patients with severe bleeding who refused endorectal surgical therapy. Method: From May 2017 to November 2018 a total of 16 patients with chronic rectal bleeding due to hemorrhoids underwent super-selective embolization of the superior rectal arteries at the department of General Surgery in La Spezia, S. Andrea Hospital, Italy. Median age was 59 years. 14 patients were males (87.5 %). Results: No post-procedural and short-term complications were observed at maximum follow up (12 months). The reduction of rectal bleeding with improvement of the quality of life was obtained in 14 patients (87.5%). Conclusion: Our study, although small in number, demonstrates that embolization of superior rectal arteries with coils to treat severe bleeding due to hemorrhoids is safe and effective and does not lead to immediate complications.

scholarly journals A New Classification for Hemorrhoidal Disease: The Creation of the “BPRST” Staging and Its Application in Clinical Practice

2020 ◽  
Vol 36 (4) ◽  
pp. 249-255 ◽  
Author(s):  
Carlos Walter Sobrado Júnior ◽  
Carlos de Almeida Obregon ◽  
Afonso Henrique da Silva e Sousa Júnior ◽  
Lucas Faraco Sobrado ◽  
Sérgio Carlos Nahas ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Strong Association ◽  
Management Strategies ◽  
Hemorrhoidal Disease ◽  
New Classification ◽  
The Past ◽  
Internal Hemorrhoids ◽  
New Treatment ◽  
Treatment Alternatives

Purpose: Present an updated classification for symptomatic hemorrhoids, which not only guides the treatment of internal hemorrhoids but also the treatment of external components. In addition, this new classification includes new treatment alternatives created over the last few years.Methods: Throughout the past 7 years, the authors developed a method to classify patients with symptomatic hemorrhoids. This study, besides presenting this classification proposal, also retrospectively analyzed 149 consecutive patients treated between March 2011 and November 2013 and aimed to evaluate the association between the management adopted with Goligher classification and our proposed BPRST classification.Results: Both classifications had a statistically significant association with the adopted management strategies. However, the BPRST classification tended to have fewer management discrepancies when each stage of disease was individually analyzed.Conclusion: Although there is much disagreement about how the classification of hemorrhoidal disease should be updated, it is accepted that some kind of revision is needed. The BPRST method showed a strong association with the management that should be adopted for each stage of the disease. Further studies are needed for its validation, but the current results are encouraging.

A Cross Sectional Study on the Outcome of Rubber Band Ligation in third Degree Hemorrhoids

2021 ◽  
Vol 15 (11) ◽  
pp. 3453-3454
Author(s):  
Rizwan Ahmad Khan ◽  
Fareeha Khaliq Khan ◽  
Maaz ul Hassan ◽  
Muhammad Naveed
Keyword(s):  
Anal Fissure ◽  
Rubber Band Ligation ◽  
Rubber Band ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Band Ligation ◽  
Operative Care ◽  
Internal Hemorrhoids

Objective: To determine the outcome of rubber band ligation in third degree hemorrhoids. Methods: - This design of this study was cross sectional study. The study was conducted at Shalamar medical and dental college, Lahore and the duration of this study was from April 2020 to September 2021. 215 patients were seen with complain of hemorrhoids, of which 47 had 3rd degree hemorrhoids. All patients with 3rd degree hemorrhoids underwent for rubber band ligation and were enrolled in the study. Outcome in our study was defined as pain, bleeding, constipation, anal fissure/fistula and infection. Chi- square test (χ2) of all qualitative variables was applied by taking p-value < 0.05 as significant. Results: - Of 47 patients admitted with 3rd degree hemorrhoid, 30 were males and 17 were females. The mean age of males was 38.78±12.71 while mean females age were found to be 22.73± 7.25 respectively. The most common complaint following rubber band ligation (RBL) was pain. 19 out of 47 patients were presented with pain followed by bleeding (14), constipation (13), anal fissure/fistula (10) and infection (8) which constitutes about 22.34 %, 22.78%15.32% and 14.03% respectively. There was significant relationship found between gender and anal fissure/fistula with p-value of <0.05. Conclusion: - Patients with 3rd degree hemorrhoids after RBL procedure showed fewer complications comparable to other surgical procedures in the treatment of hemorrhoids. It is the best possible options in third degree internal hemorrhoids. Moreover, this procedure is simple and cost-effective and requires no hospitalization, no anesthesia and no post-operative care. Keywords: - 3rd degree Hemorrhoids, Outcome, Rubber Band Ligation.

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