Sclerotherapy is a medical procedure used to address various conditions, including hemorrhoids, which are swollen veins in the rectum or anus. Many people considering this treatment often wonder about the pain involved.
What Sclerotherapy Involves
Sclerotherapy for hemorrhoids involves injecting a chemical solution, known as a sclerosant, into the submucosa, the tissue layer beneath the hemorrhoid lining. This solution irritates the blood vessel lining, causing a scarring reaction that reduces blood supply to the hemorrhoid. Over time, this process causes the hemorrhoid to shrink.
This procedure is typically performed on an outpatient basis without anesthesia. A doctor uses a proctoscope or endoscope to gain access and visualize the internal hemorrhoids. Sclerotherapy is primarily used for internal hemorrhoids, especially Grade 1 or 2, and can be an option when other treatments like dietary changes haven’t been effective. During a single session, which often takes 5 to 10 minutes, multiple hemorrhoids can be treated.
Pain Perception During the Procedure
Many individuals are concerned about pain during the sclerotherapy procedure. However, internal hemorrhoids are located above the dentate line, which has very few pain-sensing nerve endings. This anatomical characteristic means that when administered correctly, the procedure is often largely painless.
Patients typically report a mild sensation of pressure or fullness rather than sharp pain during the injection. This sensation is generally brief and subsides quickly after the sclerosant is delivered. While individual pain thresholds can vary, the lack of pain receptors in the treatment area contributes to the procedure’s well-tolerated nature.
Post-Procedure Discomfort and Recovery
Following sclerotherapy, mild discomfort, which may include a dull ache or a sensation of pressure in the rectal area, is common. These sensations are usually temporary, lasting a few hours to three days. Minor light bleeding or spotting is also expected, particularly after a bowel movement, and typically resolves on its own.
Over-the-counter pain relievers, such as acetaminophen, are often recommended to manage discomfort. Soaking in a warm sitz bath can also help soothe the area and promote healing. Most patients can return to daily activities the day after, though strenuous activities should be avoided for one to two days. Patients might also notice changes in bowel movements, such as increased frequency or urgency; stool softeners or increased fiber intake can help maintain regularity and comfort.
When to Seek Medical Attention
While sclerotherapy is generally safe, certain symptoms after the procedure warrant medical attention. Contact a healthcare professional if you experience severe or worsening pain not relieved by over-the-counter medication. Excessive bleeding (e.g., toilet water turning red or large blood clots) also requires immediate medical consultation.
Signs of infection, including fever, feeling unwell, increased redness or swelling at the injection site, or pus, indicate a need for medical evaluation. Difficulty urinating, though rare, should be reported to your doctor. An allergic reaction to the sclerosing agent, though uncommon, requires urgent medical care.