Effective Treatment for Hemorrhoids
No drug can cure hemorrhoids, and the two major types marketed for treatment carry certain risks. Ointments that contain numbing agents, such as pramoxine (Anusol, Fleet Pain Relief, Tronolane) may relieve itching and burning. Others containing hydrocortisone (generic, Cortaid Intensive Therapy, Delacort) may ease irritation and inflammation. But those treatments don't reduce bulging, bleeding, or protrusion. And using them for more than a week or so can worsen the problem: Numbing agents can irritate sensitive skin, and hydrocortisone can damage skin, increasing its susceptibility to irritation.
Acetaminophen (generic, Panadol, Tylenol) can ease the discomfort, though it too poses risks if taken at high doses, for more than two weeks or so, or by people with liver disease. Avoid aspirin, ibuprofen, and other non steroidal anti-inflammatory drugs to treat hemorrhoids since they may increase bleeding.
The most widely used medicines for hemorrhoids aren't very effective, and the long-term use of some can actually worsen the problem. The over-the-counter "remedies" that cost Americans hundreds of millions of dollars a year may ease symptoms temporarily but have not been proved to speed healing or prevent flare-ups.
Lasers, radio frequency waves and electric current are other methods of shrinking hemorrhoids. They can also be injected with solutions that cause them to collapse. That's sclerotherapy. The choice of procedure depends on the location of the hemorrhoids, how bad they are and the doctor's skill in one of the above techniques.
Several procedures to remove hemorrhoids can be performed safely in a doctor's office. Physicians can slice off external hemorrhoids quickly using local anesthesia. For internal, prolapsed hemorrhoids, the most common approach uses special rubber bands that cut off circulation to the protruding part, which then falls off in a week or so. Another, called photocoagulation, shrinks hemorrhoidal tissue with infrared light. It's slightly less effective than banding and more likely to require repeat treatments, but there's often less pain after the procedure. Our medical consultants say banding, when feasible, is generally preferable.
According to a new study, the most effective treatment for severe hemorrhoids is surgical removal. The finding contradicts the widely held belief that rubber-band ligation - the practice of cutting off circulation, causing the hemorrhoid to wither away is better.
Dr. Venkatesh Shanmugam, a clinical research fellow in the department of surgery at the Aberdeen Royal Infirmary in Scotland, said that rubber-band ligation has a good success rate, ranging from 70 to 95 per cent and a lower rate of complications but that surgery "achieved a better overall cure rate.''
In other words, patients who undergo surgery rarely require further treatment, something that cannot be said of other methods.
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