TREATMENT OPTION OF HEMORRHOIDS [PILES]
1. General and local measures
2. Schlerosant injection
3. Surgical treatment
4. The writer's experiences with medication and diet treatments
1. General measures for stage 1, 2 and 3: Control constipation by laxative drugs such as mineral oil 15-50 ml per oral at bed time; Dulcolax [brand name, generic bisacodyl ] 5 mg /tablet per oral 10 mg or suppository 10 mg at bed time; Tegaserod 2-4 mg twice per oral daily for chronic constipation.
Local measures: lubricant [petrolatum] to anal region, local anesthetic ointments for pain relief. Warm sit baths, 20-30 minutes twice daily. Rubber band ligation for internal piles only; if for external piles can effect very severe pain.The general and local measures can only reduced piles but do not heal the piles.
2. Schlerosant injection : Injection is applicable for the small internal piles [stage 1 and 2]. Injection of piles with 1 ml of 0.5 % quinine solution or
solution phenol 5 % in vegetable oil through a 22-gauge needle in one day and
repeated injections may be necessary
The piles may relief after a few injection. The complication of schlerosant
injection is about 2 %
including bleeding, urinary retention and pelvic abscess. Recurrence is
common unless patients alter dietary habits to advisable diet.
3. Surgical treatments [hemorrhoidectomy]:
Generally speaking, uncomplicated external and internal hemorrhoids usually are treated by clamp and cauterization, ligature operations of hemorrhoids. For the 4th stage and complicated piles of hemorrhoids one of varieties of hemorrhoidectomy is the Whitehead operation.
[a] Clamp and cauterization operation is used for both internal and external piles [stage 2 and 3] The sphincters are dilated, each pile grasp in turn, the external muco-cutaneous folds divided to the vascular pedicle, which is crushed by a clamp applied in the long axis of the bowel. Protecting the skin under the clamp with wet gauze, the pile is slowly burned away by a cauterization at dull red heat. The procedure is repeated with each pile, taking care not to dilate the anus again for fear of hemorrhage. The boric acid ointment is then freely applied on a gauze pad held by a T-bandage.
[b] Ligature method: The pile is exposed and liberated to the vascular pedicle as in the clamp and cauterization method. The pedicle is then ligate with catgut or silk.
[c] Whitehead’s operation: Excision of the pile-bearing area of mucous membrane has been used for very extensive pile [stage 4] conditions. The upper edge of the divided rectal mucosa is brought down and sutured to the anal margin after the excision.
The complication of operation: The operation may be followed by hemorrhage, laceration; injury and perforation of the rectum, persistent stricture [narrowing of the rectum], or stenosis [stricture] of the anus
How much the cost treatment of piles?
Estimated cost for treatment of piles by Jerry Holloway the author of “Destroy Hemorrhoids” said that the details of the cost:
• Leading hemorrhoid Ointment….$11.99
• 5-Pack Anti-Inch Cream…...…......$37.45
• Hemorrhoid Seat Cushion….….....$22.99
• Doctor’s Appointments…..…......$1075.00
• Prescription Ointments[3 tubes].$213.96
• “Preparation” Suppositories……....$18.99
• Hemorrhoids Surgery..$9 000-12 000.00
• TOTAL:……………………$13, 380.38…
This total cost of hemorrhoids treatment is expensive for middle and low income groups.
How much the cost for Writer’s experiences treatment of hemorrhoids?
The cost in Jakarta Indonesia is estimated less than $ 20.00 The cost in USA may be less than $ 50.00.
The cost for hemorrhoids surgery in Jakarta is about $2 000-3 000.00 .It is expensive for middle and low income groups.