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Class IV internal hemorrhoid. What are the treatment options?

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Gastroenterologist, Surgical
Practicing since : 1984
Answered : 922 Questions
I have a class IV XXXXXXX Hemorrhoid. What are my treatment options
Posted Sat, 14 Jul 2012 in Digestion and Bowels
Answered by Dr. Ajit Naniksingh Kukreja 8 hours later

Thanks for posting your query

If a surgeon has diagnosed it as grade four hemorrhoids which is an irreversible prolapse (we cannot put them back) with or without necrosis, the best option is Doppler Guided Hemorrhoidal Artery Ligation and Recto Anal Repair. This is evidence based procedure and painless.

Earlier Rubber Band ligation and conventional hemorrhoidectomy were being done. As there is symptomatic recurrence it is not being undertaken by experienced Colo-rectal surgeons though some still prefer to practice the same.

Hope this helps. Am available for followup queries

Wishing you good health ahead.
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