Sievering Clinic

Competence Centre for Minimally Invasive Medical Services

Haemorrhoid Treatments

Injection Sclerotherapy for Symptomatic Haemorrhoids

Injection sclerotherapy is a widely practised, effective, and generally safe method of treating first- and second-degree haemorrhoids. It consist in injecting a caustic agent (sclerosant) at the base of the haemorrhoid in order to reduce blood supply hence causing a shrinking and scaring of the haemorrhoid tissue This procedure is used to treat small internal haemorrhoids.

Many different substances have been used for injection sclerotherapy but the most popular sclerosant is 5% phenol in almond oil. It is generally safe but Retroperitoneal and subcutaneous abscesses, injection ulcers, necrotizing fasciitis, anal stricture, prostatic abscess and fistula, and superficial necrosis following sclerotherapy has been reported.
The procedure is done in a doctor’s office with no need of sedation.

Injection sclerotherapy is not a routine procedure and is done less often than other fixative procedures.
The success of injection sclerotherapy depends largely on the doctor’s expertise in the procedure and your ability to make changes in your daily habits that will make passing stools easier.
If haemorrhoids recur, injection sclerotherapy can be repeated, or another non-surgical treatment can be tried.

Why it is done
Doctors recommend injection sclerotherapy in cases where:

  • Small haemorrhoids do not improve with home treatment.
  • Internal haemorrhoids are too small to treat with rubber band ligation.
  • You have persistent bleeding from haemorrhoids.
  • You are older than age 70 or are in poor health and would not be a candidate for more invasive surgery.
How well it works
For small haemorrhoids, injection sclerotherapy relieves symptoms about as well as rubber band ligation. However, sclerotherapy does not work as well as ligation for large haemorrhoids. Haemorrhoids often recur after injection sclerotherapy. Treatments can be repeated.
Rare complications include:

  • Painful burning if the injection is given too close to the anus, where pain-sensitive nerve endings are located.
  • Allergic reaction to the injected chemical
  • Shedding of the rectal lining (mucosa), leaving an open wound (ulcer)
  • Infection of the anal area
  • Inability to control bowels or bladder (incontinence)
  • Infection of the prostate gland (prostatitis) in men
  • Bleeding
What to expect after treatment
Rectal bleeding may occur 7 to 10 days after the procedure, when the haemorrhoid falls off. Bleeding is usually slight and stops by itself.

You may use mild pain relievers to relieve discomfort. To reduce the risk of bleeding, avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) for 4 to 5 days both before and after injection sclerotherapy. Fibre rich diet is recommended. Straining during bowel movements can cause haemorrhoids to recur.