Injection Therapy for Piles

Sclerosant injection is being used for treatment of small vascular haemorrhoids and indeed used to control all cases of first degree internal haemorrhoids whatever may be the presenting symptoms. The most commonly used sclerosant is 5% phenol in almond or arachis oil with 140 mg of menthol to make 30 ml solution (Albright solution). This solution is injected into the submucosa around the pedicle of the haemorrhoid with two objects in view, firstly to produce a chemical thrombosis in the internal haemorrhoidal plexus and secondly to produce a fibrous reaction in the submucous layer which Will fix the loose redundant mucosal membrane to the inner muscle layer and draw up the pile so that it no longer prolapses or is grasped by the sphincters. Good sclerosis can often be obtained by a single injection of 5 ml into each primary haemorrhoid. If the injection is given slowly around the base of the pile above the anorectal ring then very little discomfort is experienced. If subsequent injections are required then selerosed mucosa will not usually take such large volume and 2 or 3 ml are injected 1cm below the initial injection site. The patient is examined for 4 to 6 weeks after the initial injection and in case of first degree haemorrhoids further treatment may not be necessary. In case of large second degree haemorrhoids 2 or 3 injections may be required at intervals of 6 weeks in order to obtain maximum fibrosis.
Below is the list of advantages of Injection Therapy:
(1) This method is quick.
(2) Relatively painless.
(3) Comparatively free from caution.
(4) In case of first degree haemorrhoid results indicates high percentage of cure. If injection therapy is done for treatment of first and small second degree haemorrhoids, the cure rate is in the order of 95% and recurrence may take place in less than 15% of cases within 3 years.

Below is the list of disadvantages of Injection:
(1) It is contraindicated in prolapsed piles, in arterial piles and in presence of infection.
(2) Faulty technique may lead to sloughing, which is dangerous.