The immediate response to injection therapy for first-degree haemorrhoids

Over an 8-month period, 100 consecutive patients undergoing sclerotherapy for first-degree haemorrhoids were issued with a questionnaire to assess responses to this treatment. Success was defined as complete cessation of bleeding at defaecation. The effect on bleeding was assessed at the end of 24 hours (99 responders) and 4 weeks later (98 responders): of 61 patients (62%) with no bleeding at 24 hours, only 40 (41%) remained symptom-free at 28 days post-injection. Twelve patients were treatment failures (either unchanged or increased bleeding post-injection). More than half the patients (n = 59) experienced pain related to the injection, which was severe in 9 cases. Although only 3 patients expressed complete dissatisfaction with the treatment they received, and overall 88% were either cured of bleeding or improved, the results suggest that critical judgment should be exercised before recommending the treatment to patients with minimal occasional bleeding due to first-degree haemorrhoids.