Endoscopic retrograde hemorrhoidal sclerotherapy using 23.4% saline: a preliminary report.

Historically, injection sclerotherapy has had a prominent role in the treatment of symptomatic hemorrhoids. Concern over sclerosant-related morbidity and dissatisfaction with anoscopic injection techniques has limited the application of this modality in the United States. This study reports an initial evaluation of 23.4% saline, used as a nonallergenic sclerosant, in the flexible endoscopic treatment of symptomatic internal hemorrhoids. Initial results in 19 patients with symptomatic grade I, II, or III hemorrhoids suggest that the technique is very effective in relieving bleeding, and frequently alleviates prolapse as well. The technique has proven to be well tolerated and associated with high patient satisfaction and low complication rates, with no serious complications noted. This modality is eminently suited for single session examination and therapy of the patient undergoing endoscopic evaluation for lower gastrointestinal bleeding whose findings are limited to hemorrhoidal disease.