Grade I, II, and III internal hemorrhoids are common and easily treatable, leading to new opportunities for medical professionals. The optimal treatment depends on the severity and location of the hemorrhoids.
EXPAND YOUR PRACTICE WITH NON-SURGICAL ANOSCOPIC TREATMENTS
Physicians typically address Grade I internal hemorrhoids with a combination of over-the-counter medications, dietary changes (i.e. increased fiber and water consumption), and modification of personal habits, such as using moistened, medicated pads after bowel movements instead of toilet paper. Topical corticosteroids and analgesics are useful for managing perianal skin irritation, but prolonged use of potent corticosteroid preparations may be harmful and should be avoided. A healthier, more permanent solution to internal hemorrhoids is non-surgical anoscopic treatments such as rubber band ligation.
While some Grade I and II hemorrhoids respond to medical therapy, those with recurrent or chronic internal hemorrhoidal symptoms and Grade III hemorrhoids often require non-surgical anoscopic therapies, also known as “fixative treatments,” to control recurrent bleeding or other symptoms. Non-surgical treatments, which are typically performed in an office setting, include:
- Sclerotherapy
- Infrared coagulation
- Rubber band ligation
TREAT PATIENTS & AVOID SURGERY WITH RUBBER BAND LIGATION
Several clinical practice guidelines and meta-analyses recommend non-surgical procedures for hemorrhoids of Grades I through III. Rubber band ligation is widely considered the gold standard for internal hemorrhoid treatment both because it is easy to perform and affects such a large number of patients. It is also of the most common hemorrhoid procedures performed worldwide.
A surgical hemorrhoidectomy should be reserved for Grade IV hemorrhoids and for Grade III lesions that do not respond to other treatment options. This procedure is performed in a hospital or an ambulatory surgery center and requires anesthesia. If internal hemorrhoids are discovered before they reach Grade IV, rubber band ligation can prevent the need for surgery later in the patient’s life.
