A 45-year-old male patient presents with intermittent rectal bleeding and discomfort during bowel movements for the past several months. On physical examination, he is found to have grade-2 hemorrhoids, which prolapse during defecation but spontaneously reduce.
The treatment of choice for grade-2 hemorrhoids is:
A. Band ligation
B. Open haemorrhoidectomy
C. Electro-coagulation
D. Stool softener
The Correct Answer is: A. Band ligation
Explanation:
Band ligation:
Band ligation is considered the treatment of choice for grade-2 hemorrhoids. This minimally invasive procedure involves placing a tight rubber band around the base of the hemorrhoid, cutting off its blood supply, which causes the hemorrhoid to shrink and eventually fall off. Band ligation is effective for grade-2 hemorrhoids, which prolapse during defecation but reduce spontaneously. It is a simple outpatient procedure with a high success rate and minimal complications.
Explanation of Incorrect Options:
B. Open haemorrhoidectomy:
Open haemorrhoidectomy is a surgical procedure used to remove severe or complicated hemorrhoids. While it is effective, it is generally reserved for more advanced cases, such as grade-3 or grade-4 hemorrhoids, which do not respond to less invasive treatments. It is not typically the first-line treatment for grade-2 hemorrhoids due to its invasive nature and longer recovery time.
C. Electro-coagulation:
Electro-coagulation is a procedure that uses electrical current to coagulate and shrink hemorrhoidal tissue. It can be used for the treatment of hemorrhoids, but it is less commonly employed than band ligation for grade-2 hemorrhoids. It may be more suitable for smaller hemorrhoids or those that do not respond to initial treatments.
D. Stool softener:
Stool softeners are useful for managing symptoms and preventing the progression of hemorrhoids by reducing straining during bowel movements. However, they do not directly treat the hemorrhoids themselves. Stool softeners can be part of a comprehensive management plan but are not considered the treatment of choice for grade-2 hemorrhoids.
Given these considerations, band ligation (Option A) is the treatment of choice for grade-2 hemorrhoids, as it effectively addresses the prolapsing hemorrhoidal tissue with a minimally invasive approach.