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Hemorrhoid Treatment Options

Conservative Treatment Options:

The level of treatment is based on the degree of the hemorrhoid. THD is indicated for symptomatic internal hemorrhoids, 2nd, 3rd and 4th degrees.Consult a physician to discuss the various treatment options.

  • 1st Degree: Because most hemorrhoids “shrink” or heal on their own, conservative therapy will often reduce the symptoms. Lifestyle alterations, dietary changes, topical ointments and mediations may be needed. Additionally, sclerotherapy or infrared coagulation may be a benefit.
  • 2nd Degree: Lifestyle alterations, dietary changes, topical ointments and mediations may be needed. Sclerotherapy, infrared coagulation, as well as, banding may be a benefit. Problematic II Degree hemorrhoids may require hemorrhoidectomy or THD.
  • 3rd Degree: Lifestyle alterations, dietary changes, topical ointments and mediations may be needed. Additionally, they may require hemorrhoidectomy, stapled hemorrhoidopexy or THD.
  • 4th Degree: Lifestyle alterations, dietary changes, topical ointments and mediations may be needed. Additionally, they may require hemorrhoidectomy, stapled hemorrhoidopexy or THD.

THD - The Minimally Invasive Treatment Option:

THD – Transanal Hemorrhoidal Dearterialization
THD uses a Doppler to locate the terminating branches of the hemorrhoidal arteries. Once the artery is located the surgeon uses an absorbable suture to ligate or “tie-off” the arterial blood flow. The venous “out flow” remains to “shrink” the cushion. This is done without excision of tissue. If necessary the surgeon will perform a hemorrhoidopexy to repair the prolapse. Again, this is done with suture and no excision of tissue. This repair restores and “lifts” the tissue back to its anatomical position.

The entire procedure is performed above the dentate line so that there is minimal discomfort. The procedure takes about 20 minutes and is offered as an out-patient surgery.

Be sure to consult a physician to discuss the THD procedure.

Progressive Treatment Options:

Rubber band ligation
This procedure is usually done by a surgeon in an outpatient clinic or office. The hemorrhoid is grasped by the surgeon and a rubber band is then placed at the base of the hemorrhoid. This cuts off the blood supply to the cushion and over time the tissue below the band dies and scarring occurrs. There is often the need to repeat the procedure to resolve the problem.

Stapled hemorrhoidopexy
The hemorrhoidal cushions are removed by utilizing a circular stapler to excise a band of tissue within the anal canal. Once the tissue is removed the mucosa is reapproximated with the stapling device.

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