eP411 - The Effect of Injectable Sclerotherapy with Polidocanol Foam in Treating Hemorrhoids in Patients with Severe Anemia

Purpose/Background: The objective of this study was to assess the efficacy of injectable sclerotherapy with polidocanol foam in patients with hemorrhoids and severe anemia, utilizing HDSS in conjunction with SHS for evaluation. Currently, studies have identified a specific type of hemorrhoid called anemic hemorrhoids, characterized by severe bleeding compared to ordinary hemorrhoids . Moreover, conservative treatment usually does not work while the risk of surgical treatment is quite high for these types of patients. Injectable sclerotherapy is one of the treatment options for both hemorrhoids and vascular malformations. Notably, it is particularly effective in managing bleeding hemorrhoids. Additionally, injectable sclerotherapy with Polidocanol foam is currently utilized as an interim therapy to alleviate symptoms such as bleeding, prolapse, and itching. However, further investigation is necessary to substantiate the effects on patients with severe anemia and evaluate patient satisfaction and long-term follow-up efficacy . Therefore, we conducted a retrospective study at Longhua Hospital Shanghai University of Traditional Chinese Medicine to examine the therapeutic effect of injectable sclerotherapy with Polidocanol foam on patients presenting severe anemia and hemorrhoidal disease. The Hemorrhoidal Disease Symptom Score (HDSS) in conjunction with the Short Health Scale (SHS) were employed for assessing its efficacy.Methods/Interventions: Patients with grade II and III hemorrhoids and severe anemia who underwent injectable sclerotherapy using 3% polidocanol foam between February 2022 and May 2023 at the Department of Proctology, Longhua Hospital Shanghai University of Traditional Chinese Medicine were included in this study. The patients' hemoglobin (Hb) levels, HDSS scores and SHS scores before and after treatment were collected. Follow-up visits were scheduled once a week during the first month after discharge, followed by every three months to monitor patients' clinical symptoms and determine if further treatment was necessary.Results/Outcomes: A total of 16 patients with hemorrhoids and severe anemia were enrolled in the study. The mean age of the patients was 47.31 (20-90, 47.31±19.2) years, with a pre-treatment hemoglobin level of 60.06 (39-79, 60.06±12.76) g/L. The Hemorrhoidal Disease Symptom Score (HDSS) score and Short Health Scale (SHS) score were recorded as 8 and 24 respectively. All patients' bleeding symptoms resolved during the three-month follow-up period, and statistically significant improvements were observed in hemoglobin levels 105.87 (80-135, 105.87±17.24) g/L, HDSS score (reduced to 5), and SHS score (reduced to 9) (p < 0.001). Three patients experienced recurrence of prolapse symptoms during the six-month follow-up period, leading two of them to undergo hemorrhoidectomy. Overall, all patients expressed high satisfaction with injectable sclerotherapy.Conclusion/

Discussion: The use of Polidocanol foam in injectable sclerotherapy demonstrates a highly promising effect on patients suffering from severe anemia hemorrhoids. This procedure is characterized by its simplicity, timeliness, and safety. It effectively treats hematochezia and creates favorable conditions for subsequent hemorrhoidectomy."Presentation of the case

Flow chart of the study
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