Tayyab Abbas, Omer F M, Abid N, Waseem S, Sajid I, Muhammad A, Husnain S, Amber R, Syed A S.
Management of bleeding hemorrhoids in anemic patients.
Pak J Gastroenterol Jan ;20(1):14-7.

This is a prospective, randomized study of the management of thirty patients suffering from anemia due to bleeding hemorrhoids. Patients with hemoglobin 8 or less than 8gm%, were included in this study. Six patients were suffering from first degree, three patients from early second degree, two patients from late second degree and rest of the nineteen patients (61%) were of third degree hemorrhoids. Twenty four patients were male and six were females. The median age of the patients was 32 years.Two patients were diabetic and five were suffering from chronic liver disease, (CLD). Proctosigmoidoscopy and injection of sclerosing agent was done immediately after clinical examination of the patients. There was uneventful) stoppage of bleeding in all patients. Five patients required blood transfusion and in rest of the 25 patients, hemoglobin was restored with diet and hematinics. Standard treatment of hemorrhoids was completed within one month with hemorrhoidectomy or with further sessions of injection sclerotherapy, according to the degree of the hemorrhoids. The median follow up period was 3 months.Injection sclerotherapy, regardless of degree of hemorrhoids, followed by standard treatment is a safe and effective method for the management of the patients with bleeding hemorrhoids having low hemoglobin.

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