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Surgery is favored treatment for severe hemorrhoids

line of treatment. Numerous ointments are available to treat hemorrhoid symptoms but the review says that there is "little objective evidence of their efficacy."

Hemorrhoid disease is ranked first among the diseases of the rectum and large intestine. About half the U.S. population has experienced hemorrhoids by age 50. Men are more frequently afflicted than women, and the peak incidence of the disease occurs between the ages of 45 and 65.

Although patients undergoing RBL spent significantly fewer days away from work than patients subject to surgery, the reviewers say the escalating cost of repeated RBL procedures needs to be considered before definite conclusions are reached about the relative economic effect of the two procedures.

The review also made note of stapled hemorrhoidopexy as a new alternative to surgery, indicating that its standing as a treatment alternative awaits evaluation of the long-term results of the procedure.

Scott Thornton, M.D., a surgeon at Bridgeport Hospital in Connecticut and an assistant professor at Yale University School of Medicine, says that "rubber band ligation is painless in 80 percent of patients and done in an office setting with no anesthesia and with no time missed from work." He says that RBL prompts complications in only about 1 percent of cases as compared with surgery, which prompts complications in 5 percent to 8 percent of cases.

"My own view is that RBL is pretty darn effective as a first treatment option," Thornton says. "I'll bet," he adds, that if the reviewers "were taking care of hemorrhoids of their own, they would opt for rubber band ligation because there is a very significant amount of pain involved with an excisional hemorrhoidectomy."


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Contact: Venkatesh Shanmugam
venki411@yahoo.co.uk
Center for the Advancement of Health
19-Jul-2005


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