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Date of last update: 8/19/2017.

Forum Name: Surgery Topics

Question: sclerotherapy for internal Piles worsened my external ones.

 fellowship - Fri Aug 13, 2010 2:57 pm

Hello doc,
I have mixed internal and external piles.
symptoms started about 1 year ago. it was asymptomatic masses that bulge upon straining and then spontaneously disappear shortly after defecation.since last time they started to bleed upon straining (only once) the blood was fresh,small amount and separated from feces ( at end of defecation)..i directly checked a surgeon, underwent flexible sigmoidoscoy which was normal...on same setting all 3 internal piles where injected with a sclerosing agent.( they were not large enough for band ligation).during and after the procedure i was fine and it was painless..but since i back to home the external pile was rendered swollen with moderate discomfort that developed into continuous moderate aching.
now i am on diclofenac and lidocaine cream plus lactulose..
my question.
1-is my complain normal outcome of the procedure,is it serious !
2-how long it takes for my pain and swollen external piles to return normal-i am in 4th day post procedure and still in pain whenever i stop taking the diclofenac.
3-in case what i have was thrombosed external piles, does that alter my management path or it is ok to go with my current medications.
4-does sitting for long time worsen the piles.can i still sit on chair with such swollen external piles.( i usually spend 8 hrs on a chair daily)

i will be much appreciating for ur help.
 Dr.M.Aroon kamath - Fri Aug 13, 2010 10:05 pm

User avatar Hi,
As your internal pile masses were injected recently, swelling of the external ones is not unusual. The sclerosing agent causes a chemical inflammation which induces fibrosis and eventual occlusion of the internal pile masses.The sclerosant injection, by causing local lymphatic blockade,may temporarily aggravate the exteranal pile masses.

It is advisable(as you are symptomatic),not to sit for too long. It will help you to elevate the foot end of your bed and lie down most of the time for a couple of days. This will aid lymphatic drainage and reduce the local edema(and pain). Sitz baths also help. Avoid straining. I am sure, your doctor might have advised you already abut these aspects.
Best wishes!

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