Sclerotherapy is a non-surgical treatment in which a doctor will inject a solution called sclerosant directly into blood vessels, causing irritation that makes the vessel swell. That swelling leads to blood flow to the vessel being cut off, which results in it shrinking in size. It is most often used to treat varicose veins (or spider veins), but it can also be used to tackle haemorrhoids, as well as disorders of the blood and lymph vessels. Sclerotherapy has existed in a variety of forms since the 19th century, and approaches to it have vastly improved over the course of time.
Sclerotherapy is primarily used to treat varicose veins (also known as chronic venous insufficiency). It can lessen the appearance and associated symptoms of varicose veins, making them more manageable for sufferers.
The treatment is also used to tackle malformed lymph vessels, which carry lymphatic fluid or lymph around the body to help the immune system stave off infection. It can also be used to treat hydrocele, which are unhealthy build-ups of fluid inside a cavity in the body (these can often occur in the testicles).
Sclerotherapy is also used to treat haemorrhoids, especially in the event that other forms of treatment have proved to be ineffective.
Not everyone who has varicose veins, malformed vessels or haemorrhoids needs to opt for sclerotherapy, however. Medical professionals can recommend a number of different approaches to address these issues. In the case of haemorrhoids, for instance, non-prescription treatments can often reduce or eradicate them completely without the need for more extreme methods or surgery. Simply altering your diet or lifestyle can help sufferer’s manage their haemorrhoids without needing to consider sclerotherapy, or other similar approaches.
A sclerotherapy procedure can be carried out in the office of a dermatologist or GP – this will happen following a consultation with the doctor to determine the best course of action in terms of treatment. The procedure does not require the use of anesthetics or any similar such approach, though your doctor may provide you with a number of specific instructions to prepare for the treatment in advance.
When performing the procedure for piles, the doctor first cleanses the haemorrhoid area before a hardened chemical solution is injected directly into the vein, causing the tissue to scar and drastically lower the blood supply to the pile. After a short time, the blood vessel collapses, causing the haemorrhoid to shrink and go hard – it will eventually shrivel up entirely after around 4 to 6 weeks following treatment. Multiple haemorrhoids can be injected during the same procedure.
After the procedure is complete, a follow-up treatment is sometimes required to ensure that the blood vessel is fully collapsed and the haemorrhoid has shrunk sufficiently. Multiple treatments may be required for several haemorrhoids, but this is uncommon.
In the days following treatment, patients should remain active in order to avoid blood clots forming in the region, though it’s important to keep exercise light and avoid any heavy lifting or straining on the toilet. There may be some degree of tenderness and discomfort in the haemorrhoid region following the procedure, but this will pass quickly. Any pain can be treated with basic analgesic medication or painkillers.
Sclerotherapy is most commonly recommended by doctors when patients fail to respond to other forms of haemorrhoid treatment, though more basic approaches are often successful.
Sclerotherapy is considered a fairly safe procedure as it is much less invasive than surgery and has a significantly lower risk level. It also does not require anaesthesia, which is a major bonus.
In terms of varicose veins, sclerotherapy has been proven to work in 75-90 per cent of instances, but numerous treatments are often needed to fully resolve the issue. It is more straightforward when used to treat haemorrhoids. There are, however, a small number of potential side effects to the procedure, including bruising, redness and discomfort around the haemorrhoid region following successful treatment.
Patients may also experience mild pain following the days or weeks after their treatment, and may find that they have light rectal bleeding on and off for a short time after the procedure has been performed.
In rare cases, patients can experience an allergic reaction to the solution, which causes a burning sensation in the area; it is also possible for very small air bubbles to enter the bloodstream through the needle and cause headaches, nausea and problems with vision.
In the rarest of cases, a blood clot can appear in the treated blood vessel. These can be serious and life-threatening as they can travel through the bloodstream to other organs and cause major problems, such as an embolism. Anyone who experiences chest pain or has difficulty breathing following sclerotherapy should contact the emergency services at once.
Recovery and future of sclerotherapy
During the recovery period, patients are likely to experience discomfort or a sensation of ‘fullness’ in the anus in the days following the procedure. Painkillers can be taken to reduce any discomfort, and recovering individuals can generally go about their daily lives as normal.
In some cases, patients may find spots of blood on their stool or on toilet paper after cleaning their anal region following a bowel movement, but this will pass quickly.
The NHS recently announced plans to reduce its use of up to 17 surgical procedures in an effort to save £200million per year. Treatments that are deemed “ineffective or too risky” will be avoided, meaning there will be up to 100,000-fewer procedures performed every year. Certain treatments for varicose veins and haemorrhoids will only be performed if the medical need for them is considered pressing or other approaches have failed.
The national medical director, Professor Stephen Powis, explained: “If we want the very best clinical care for our patients, we need to stop putting them through treatments where risks and harms outweigh the benefits.
“By reducing unnecessary or risky procedures for some patients we can get better outcomes while reducing waste and targeting resource to where it is most needed.” Click here
Though this announcement may have only a limited affect on sclerotherapy procedures, it certainly could have some bearing on other forms of haemorrhoid treatment.