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Monday, August 5, 2013

Hemorrhoid Treatment

                                                   Hemorrhoid Treatment-Part 2

It is not Colonoscopy Chronicles’ intention to provide specific medical advice to users of its blog, instead we provide users with information to help them better understand their health, diagnosed conditions, and the current approaches related to treatment, prevention, screening, and supportive care. Colonoscopy Chronicles urges users to consult with a qualified health care professional for diagnosis and answers to their personal medical questions.

In our last post, we discussed treatment of hemorrhoids. As I indicated, I am a strong proponent of hemorrhoid banding in those patients in whom it is appropriate to treat their internal hemorrhoids. The technique I use involves the CRH System for hemorrhoid banding. The company that makes the equipment has a fairly helpful website that describes the equipment and the technique in some detail.

Having been involved in banding hemorrhoids for almost 25 years, I have found the CRH System the best one for my patients. First of all it is safe. Like any medical intervention, hemorrhoid banding has potential complications. The most common "complication" is the one that patients are usually the most concerned about-pain. Patient's, quite understandably, are worried about how painful the procedure will be. And in fact, with some techniques there can be a significant chance of pain after the procedure(32% in on published series from 2005). However, using the CRH system, the risk of significant pain after the procedure is less than 1% !!

I do not promise my patients that the technique is totally painless-since I would rather underpromise and overdeliver. I counsel them to expect a mild pressure-like sensation, or a slight pinching, which usually resolves within a few hours. Usually no intervention is necessary for such monir discomfort, however, I encourage patients to use Tylenol(acetominophen), or Advil(ibuprofen) as needed-as long as they are not allergic to those medications of have no other medical contra-indication. I always find it gratifying when we finish the procedure, and patients look at me in disbelief, and say"Is that it?

Bernal JC, Enguix M, López García J, García Romero J, Trullenque Peris R. Rubber-band ligation for hemorrhoids in a colorectal unit. A prospective study. Rev Esp Enferm Dig. 2005/01;97[1]:38-45

O'Reagan PJ. Disposable devices and a minimally invasive technique for rubber band ligation of hemorrhoids. Dis Colon Rectum 1999; 42(5): 683-5.