Treatment of choice for 3rd degree hemorrhoids is: September 2007
Ans. C: Hemorrhoidectomy External hemorrhoids develop around the rim of the anus. External hemorrhoids cause most of the symptoms associated with hemorrhoids (pain, burning, and itching) because the skin around them is very sensitive. If an external hemorrhoid becomes strangulated, a clot can form in it and become an excruciatingly painful thrombosed hemorrhoid. Internal hemorrhoids develop inside the passageway of the anus. Internal hemorrhoids are often present without causing any discomfo or even awareness of their presence. Internal hemorrhoids are usually painless, although they sometimes cause discomfo and bleeding if a hard stool rubs against them during a bowel movement. Internal hemorrhoids also may prolapse outside the anus, where they appear as small, grape-like masses. These can be painful. Internal hemorrhoids are classified by the degree of tissue prolapse into the anal canal: First-degree - hemorrhoids that bleed but do not prolapse Second-degree - hemorrhoids that prolapse with straining or defecating and retract on their own Third-degree - hemorrhoids that prolapse and require manual reduction Fouh-degree - hemorrhoids that chronically prolapse and, if reducible, fall out again Management: Rubber band ligation - A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days. Sclerotherapy is one of the oldest forms of treatment. A chemical solution is injected directly into the hemorrhoid or the area around it. This solution causes a local reaction that interferes with blood flow inside the hemorrhoid, making the hemorrhoid shrink. Laser or electro-coagulation techniques - Both techniques use special devices to burn hemorrhoidal tissue. - Cryotherapy uses cold temperatures to obliterate the veins and cause inflammation and scarring. It is more time consuming, associated with more posttreatment pain, and is less effective than other treatments. Therefore, this procedure is not commonly used. - Hemorrhoidectomy - Occasionally, extensive or severe internal or external hemorrhoid may require removal by surgery known as hemorrhoidectomy. This is the best method for permanent removal of hemorrhoid Hemorrhoidectomy is the treatment for: Severe third-degree and fouh-degree hemorrhoids. Second degree hemorrhoids that have not been cured with conservative measures. Fibrosed hemorrhoids Interno-externo hemorrhoids when the external hemorrhoid is well defined.
Sclerotherapy
Band ligation
Hemorrhoidectomy
All of the above