{"id":9243,"date":"2025-10-27T13:13:46","date_gmt":"2025-10-27T13:13:46","guid":{"rendered":"https:\/\/www.betaklinik.de\/?page_id=9243"},"modified":"2025-11-03T10:07:24","modified_gmt":"2025-11-03T10:07:24","slug":"hemorrhoids-hemorrhoidal-disease-treatment","status":"publish","type":"page","link":"https:\/\/www.betaklinik.de\/en\/specialties\/general-surgery-and-colorectal-surgery-proctology\/hemorrhoids-hemorrhoidal-disease-treatment\/","title":{"rendered":"Hemorrhoids \/ hemorrhoidal disease treatment"},"content":{"rendered":"\t\t
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Hemorrhoids \/ hemorrhoidal disease treatment<\/h1>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t\t
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Subject to the stage of the hemorrhoidal disease, the following treatment options are carried out:<\/p>

  • sclerotherapy<\/li>
  • rubber band litigation<\/li>
  • Milligan-Morgan procedure<\/li>
  • stapled hemorrhoidopexy (Longo\u00b4s procedure)<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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    Sclerotherapy<\/h2>

    Sclerotherapy (= shrinking blood vessels; may cause skin irritations) is a treatment for stage I-II of hemorrhoidal disease. During this procedure, we inject a sclerosing solution (e.g., Aethoxysklerol\u00ae) just above the hemorrhoids into the mucous membrane. This causes a scarring process that helps shrink and fix the hemorrhoids. Administered correctly, the low-risk sclerotherapy is painless. Main risk: a rare, slight bleeding after the procedure.<\/p><\/div><\/div><\/div><\/div><\/div><\/div>

    Rubber band litigation<\/h2>

    Rubber band litigation is a treatment for stage II (-III) of hemorrhoidal disease. During this painless procedure, we insert a specific applicator through the open proctoscope (tube) in order to stanch an area of the mucous membrane just above the hemorrhoid by using a rubber band. The treated part of the mucous membrane falls off together with the rubber band after a few days. This causes scarring that shrinks and fixes the hemorrhoids. Main risk: bleeding 2-3 days after the procedure.<\/p>

    Milligan-Morgan procedure<\/h2>

    For several decades, the Milligan-Morgan procedure has been established as standard surgical treatment of hemorrhoidal disease. We perform a slightly modified version of the Milligan-Morgan procedure to treat stage III-IV of hemorrhoidal disease (III: in case of single prolapsed hemorrhoids, outpatient treatment; IV: in case of several fixed prolapsed hemorrhoids, inpatient-treatment). It is undergone under general or regional spinal anesthesia.
    Preparation: Please do not eat solid food at the evening before surgery and take a Bisacodyl\u00ae suppository; micro-enema on the day of surgery.<\/p><\/div><\/div><\/div><\/div><\/div><\/div>

    How is the Milligan-Morgan procedure performed?<\/h2>

    At the beginning of the Milligan-Morgan procedure, a rectal examination (inspection, feeling for anomalies with fingers) and rectoscopy\/proctoscopy (inserting a rectoscope for better vision) are carried out under anesthesia. It is followed by disinfection, covering and the insertion of an anal spreader.<\/p>

    Local anesthesia with adrenalin is optional. It reduces the pain and bleeding during surgery.<\/p>

    Protecting the anal sphincter, the enlarged hemorrhoid is electrosurgically removed, and the supplying blood vessels are sutured. The wound inside the anal canal is not stitched up on purpose. The removed tissue undergoes a histological examination at a laboratory.<\/p>

    After controlling the results and stanching the blood, an lidocaine ointment is administered inside the anal canal.<\/p><\/div><\/div><\/div><\/div><\/div><\/div>

    Aftercare Milligan-Morgan procedure<\/h2>

    Passing stool after the Milligan-Morgan procedure is possible without constraints. The anal region should be showered with lukewarm water afterwards. Subsequently, a gauze swab with a lidocaine-panthenol ointment is applied. Taking painkillers is necessary for 1 week.<\/p><\/div><\/div><\/div><\/div><\/div><\/div>

    When can I resume work?<\/h2>

    It depends on your occupation and your condition how long it takes to resume work. Generally, it is about 1-3 weeks.<\/p><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    Stapled hemorrhoidopexy (Longo\u00b4s procedure)<\/h2>

    Stapled hemorrhoidopexy, also called Longo\u00b4s procedure, has been a standard procedure to treat prolapsed hemorrhoids of stage III of hemorrhoidal disease for many years.<\/p>

    During stapled hemorrhoidopexy, a layer of mucous membrane is removed just above the hemorrhoid, using a circular stapler, and the wound is sutured with titanium staples. The lower rectum is \u201clifted\u201d, and the flow of blood of hemorrhoid-supplying arteries is reduced.<\/p><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\n\t\t