Tests and treatments
Haemorrhoid: non-surgical treatment
When is it indicated?
In the first instance, all patients with haemorrhoids are advised to follow a certain lifestyle regimen. In some cases, these measures can clearly reduce the symptoms or even eliminate them altogether. If the haemorrhoids nevertheless continue to cause discomfort, other measures are appropriate.
There are three different non-surgical techniques for treating symptomatic haemorrhoids.
Different non-surgical treatments
1. Infrared treatment or injection for haemorrhoids
What is it?
Both techniques involve shrinking the swollen haemorrhoids. They are especially indicated for limited numbers of internal haemorrhoids; in advanced cases, surgery is often advised.
Infrared coagulation involves using infrared light to scar the swollen haemorrhoids, causing them to shrink.
Sclerotherapy injections involve the introduction of an irritant beneath the mucous membrane, causing the haemorrhoids and swelling to shrink.
These treatment methods are relatively pain free and cause few side effects. Sometimes, multiple sessions are necessary to get the symptoms under control. They are performed by gastroenterologist colleagues.
2. Rubber band ligation
What is it?
This involves grasping the haemorrhoid using a suction tube and placing a rubber band over the base of the haemorrhoid. The band ties off the haemorrhoid and, after seven to ten days, the haemorrhoid and excess mucous membrane will fall off and disappear when you have a bowel movement. The remaining scar causes some shrinking and for that reason, there is usually no fast recurrence. Multiple bands can be placed during a single procedure. And the procedure can be repeated at a later date, if necessary.
The main side effects of this treatment are limited pain and some urge to have a bowel movement. If light painkillers (paracetamol) are not enough or if the urge to have a bowel movement remains very strong, the rubber band may need to be removed.
Because the area around the haemorrhoids has good blood supply, some blood loss may occur immediately after the procedure or when the haemorrhoid falls off. In case of substantial blood loss, you are advised to contact the Surgery Department or, if necessary, A&E.
In case of fever, a local infection must be ruled out. In rare cases, urinary retention may occur.
3. Removal of skin tags
What is it?
Skin tag removal is sometimes advised for hygienic reasons. For smaller skin tags, this can be done under a local anaesthetic as an outpatient in the minor surgery clinic. This involves the minor discomfort of the injection for the local anaesthetic but apart from that, the procedure is usually very well tolerated. For larger tags, removal under a brief general anaesthetic is sometimes advisable.
After the procedure, you may have anal wound pain for a few weeks. This will be especially noticeable during bowel movements. You may also experience some pain when the self-absorbing sutures are touched. If the sutures disappear at an early stage due to wiping, the wound may reopen partially. This will sometimes cause temporary blood loss or pus loss. In some situations, it may be advisable to apply a protective cream daily.
Surgical treatment of haemorrhoids
If the haemorrhoids do not, or insufficiently respond to, the above treatments, a more drastic treatment may be necessary. There are various options for this as well. Read more about the available surgical treatments for haemorrhoids here.
Centres and specialist areas
Latest publication date: 05/02/2021
Supervising author: Dr Pletinckx Pieter