Nisar and Scholefield(1) have provided a comprehensive review of
managing haemorrhoids. However they have failed to mention some other
treatment modalities, which may be tried before proceeding to surgery.
One of these is infrared photocoagulation, which produces infrared
radiation just proximal to the internal haemorrhoid plexus. This leads to
coagulation of the tissue and hence fibrosis. The device is applied for
1.5 seconds in 2 to 3 sites proximal to the haemorrhoidal plexus. Reported
results for first and second-degree haemorrhoids are as good as those for
rubber band ligation or sclerotherapy.(2) Pain and other complications are
rare.
Another modality is use of electrocoagulation and heater probes.
These work by using thermal injury to fix the internal haemorrhoidal
plexus. Both compare favourably with rubber band ligation for the
treatment of first and second-degree haemorrhoids.
Rapid Response:
Other treatment modalities for haemorrhoids
Nisar and Scholefield(1) have provided a comprehensive review of
managing haemorrhoids. However they have failed to mention some other
treatment modalities, which may be tried before proceeding to surgery.
One of these is infrared photocoagulation, which produces infrared
radiation just proximal to the internal haemorrhoid plexus. This leads to
coagulation of the tissue and hence fibrosis. The device is applied for
1.5 seconds in 2 to 3 sites proximal to the haemorrhoidal plexus. Reported
results for first and second-degree haemorrhoids are as good as those for
rubber band ligation or sclerotherapy.(2) Pain and other complications are
rare.
Another modality is use of electrocoagulation and heater probes.
These work by using thermal injury to fix the internal haemorrhoidal
plexus. Both compare favourably with rubber band ligation for the
treatment of first and second-degree haemorrhoids.
1. Nisar PJ, Scholefield JH. Managing Haemorrhoids. BMJ 2003; 327:847
-51
2. MacRae HM, McLeod RS. Comparison of haemorrhoidal treatment modalities.
A meta-analysis. Dis Colon Rectum 1995; 38: 687-94
Competing interests:
None declared
Competing interests: No competing interests