What is Sclerotherapy?

Sclerotherapy is a non-surgical procedure used to treat haemorrhoids (piles). It involves injecting a special chemical solution  called a sclerosant  directly into the haemorrhoidal tissue. This chemical causes the blood vessels feeding the haemorrhoid to harden, scar, and shrink, cutting off its blood supply. Over the following weeks, the haemorrhoid gradually shrivels up and disappears.

The word "sclerotherapy" comes from the Greek word skleros, meaning hard — which describes exactly what the injected chemical does to the abnormal blood vessels.

It is a quick, simple, and relatively painless procedure that can be performed in a clinic or outpatient setting without the need for general anaesthesia or any significant preparation. Most people walk out of the clinic and return to their normal routine the same day.

Sclerotherapy has been used to treat haemorrhoids for well over a century and remains one of the most used office-based treatments worldwide.

When is Sclerotherapy Needed?

Sclerotherapy is best suited for mild to moderate internal haemorrhoids that are causing troublesome symptoms but do not yet require surgery. Your doctor may recommend sclerotherapy when:

• You have Grade I or Grade II haemorrhoids — those that bleed or slightly prolapse but do not permanently hang outside the anus
• You have persistent rectal bleeding that has not improved with dietary changes, increased fluid intake, or topical creams
• You are looking for a quick, minimally invasive option and want to avoid surgery
• Rubber band ligation is not suitable for you — for example, if you are on blood thinners, as sclerotherapy carries a lower bleeding risk than banding
• You have small, early-stage haemorrhoids that are not yet large enough to band
• You are elderly or medically unfit for a surgical procedure

Like rubber band ligation, sclerotherapy works only on internal haemorrhoids — those located above the dentate line inside the anal canal, where the lining is not sensitive to pain. It is not used to treat external haemorrhoids.

How Do I Prepare for Sclerotherapy?

One of the great advantages of sclerotherapy is that preparation is very simple.

• No fasting is required in most cases, as the procedure does not involve general anaesthesia. You can eat and drink normally on the day.
• Bowel preparation may be recommended by some doctors — a small enema used at home a couple of hours before the appointment can help clear the lower bowel and give the doctor a clearer view. Not all doctors require this, so follow your specific instructions.
• Medications — let your doctor know about any blood-thinning medicines you take, such as aspirin, warfarin, or other anticoagulants. Unlike rubber band ligation, sclerotherapy is actually considered safer in patients on blood thinners because it carries a lower bleeding risk. However, your doctor will still review your medications before proceeding.
• No special diet or hospital admission is needed. The procedure is performed in a clinic or outpatient department, and you can drive yourself home in most cases, as no sedation is used.

What Happens During Sclerotherapy?

The procedure is very quick, typically taking only 5–10 minutes from start to finish.

You will be asked to lie on your left side with your knees drawn up towards your chest, or in a position your doctor finds most appropriate.

Your doctor will gently insert a proctoscope — a short, hollow, tube-like instrument with a light — into your anus to get a clear view of the haemorrhoids inside.

Using a fine needle passed through the proctoscope, the doctor will inject a small amount of the sclerosant solution into the tissue at the base of each haemorrhoid. The most commonly used sclerosant is phenol in almond oil, though other agents such as sodium tetradecyl sulphate or polidocanol may also be used depending on the doctor's preference and local availability.

Because the injection is given above the dentate line — in the area of the anal canal that has no pain-sensitive nerve endings — most patients feel little to no pain during the injection. You may feel a brief sensation of pressure or mild discomfort, but it passes quickly.

Multiple haemorrhoids can often be treated in a single session, which is an advantage over rubber band ligation where doctors often prefer to treat one at a time.

What Happens After Sclerotherapy?

After the procedure, you can get dressed and go home almost immediately. There is no recovery room stay required in most cases.

The injected sclerosant begins working straight away, causing an inflammatory reaction in the haemorrhoidal tissue. Over the next 4–6 weeks, the haemorrhoid gradually hardens, scars, and shrinks as its blood supply is cut off.

You may notice the following in the days after the procedure:

• Mild discomfort or a dull ache in the rectal area for 24–48 hours — this is normal and usually settles with paracetamol.
• A small amount of rectal bleeding may occur, particularly with the next few bowel movements. This is expected and usually settles on its own. However, heavy or persistent bleeding should be reported to your doctor.
• A feeling of fullness or pressure in the back passage for a day or two is also common.

Most people are able to return to work and normal daily activities the same day or the next day.

Recovering from Sclerotherapy

Recovery from sclerotherapy is generally very easy and well-tolerated.

• Pain is usually minimal. Unlike surgical haemorrhoidectomy, significant pain after sclerotherapy is uncommon. Simple over-the-counter painkillers like paracetamol are usually all that is needed for any mild discomfort in the first couple of days.
• Diet plays an important role in recovery. A high-fibre diet rich in fruits, vegetables, and whole grains helps keep stools soft and reduces the need to strain during bowel movements — which is crucial for allowing the treated area to heal properly. Aim to drink at least 8 glasses of water daily.
• Stool softeners may be recommended for the first week to make bowel movements more comfortable.
• Sitz baths — sitting in a few inches of warm water for 10–15 minutes, two or three times a day — can help soothe any mild discomfort.
• Avoid strenuous activity and heavy lifting for 24–48 hours after the procedure, though light walking and normal daily tasks are perfectly fine.

Results are not always immediate. It typically takes 4–6 weeks to see the full benefit as the haemorrhoidal tissue gradually shrinks. Bleeding is usually the first symptom to improve. If symptoms persist after this period, a repeat session or alternative treatment may be considered.

What are the Risks of Sclerotherapy?

Sclerotherapy is considered a very safe procedure with a low complication rate. However, as with any medical treatment, there are some risks to be aware of:

• Common and minor side effects include mild pain or discomfort for 1–2 days, a temporary sensation of pressure in the rectum, and minor bleeding during the next few bowel movements after treatment.
• Less common complications include ulceration — the chemical can occasionally cause a small ulcer to form in the rectal lining, which usually heals on its own. Some patients may experience a mucous discharge from the anus for a short period after treatment.
• Rare complications include inadvertent injection of the sclerosant into the wrong tissue. If the chemical is injected too deeply, it can cause damage to surrounding structures. Injection into the prostate gland in men — causing prostatitis (inflammation of the prostate) — is a rare but recognised complication that can result in urinary symptoms and pelvic pain. Injection into the wall of the rectum can also very rarely lead to the formation of an abscess or fistula.
• Allergic reaction to the sclerosant solution is extremely rare but possible. Inform your doctor if you have any known allergies before the procedure.
• Recurrence of haemorrhoids over time is possible, especially if lifestyle factors like constipation and straining are not addressed.

Overall, the risk of serious complications from sclerotherapy is very low, making it one of the safest available treatments for internal haemorrhoids.

Who Shouldn't Have Sclerotherapy?

While sclerotherapy is safe for most people, it is not suitable in certain situations:

• External haemorrhoids cannot be treated with sclerotherapy, as injecting the sclerosant below the dentate line would cause severe pain and tissue damage.
• Grade III or IV haemorrhoids — those that prolapse significantly or are permanently outside the anus — are generally too large to respond adequately to sclerotherapy alone. These cases usually require rubber band ligation or surgery.
• Active anorectal infection or inflammation — sclerotherapy should not be performed if there is an active abscess, fistula, or significant inflammation in the anal region.
• Inflammatory bowel disease — patients with Crohn's disease involving the anorectal area are not good candidates, as healing can be severely impaired.
• Known allergy to the sclerosant — patients with a documented allergy to phenol or other sclerosant agents should not undergo this treatment.
• Pregnancy — while not absolutely contraindicated, the procedure is usually deferred until after delivery unless symptoms are particularly severe.

Your doctor will take a full medical history and examine you before recommending sclerotherapy to make sure it is the right treatment for you.

How Many Sessions Will I Need?

The number of sessions required varies from person to person depending on the size and number of haemorrhoids being treated.

Many patients with small, uncomplicated haemorrhoids see good results after just one or two sessions. Those with multiple haemorrhoids or larger Grade II haemorrhoids may need 3–4 sessions in total.

Sessions are typically spaced 4–6 weeks apart to allow the treated tissue to heal and scar properly before the next injection is given.

After completing your course of treatment, your doctor will review your progress. If sclerotherapy has not produced satisfactory results, they may recommend stepping up to rubber band ligation or, in more advanced cases, surgical haemorrhoidectomy.

How Effective is Sclerotherapy?

Sclerotherapy is effective for mild to moderate internal haemorrhoids, particularly for controlling bleeding. Studies show that it successfully stops bleeding in approximately 75–85% of patients with Grade I and Grade II haemorrhoids.

However, when compared directly to rubber band ligation, banding tends to produce better and longer-lasting results, particularly for Grade II and III haemorrhoids. Rubber band ligation is therefore generally considered the preferred first-line office procedure for higher-grade haemorrhoids, while sclerotherapy is particularly useful for Grade I haemorrhoids and for patients in whom banding is not suitable — such as those on blood thinners.

Like all non-surgical treatments, sclerotherapy does not permanently prevent haemorrhoids from recurring. Long-term success depends heavily on maintaining a healthy, high-fibre diet, staying well hydrated, avoiding prolonged straining or sitting on the toilet, and keeping bowel habits regular. With these lifestyle measures in place, the results of sclerotherapy can be sustained for many years.

Why choose Tender Palm Super-Speciality Hospital for Sclerotherapy in Lucknow, India?

Tender Palm Super-Speciality Hospital is one of the best hospitals for Sclerotherapy in Lucknow, India. Our experienced colorectal and proctology specialists use advanced sclerotherapy technique to safely and effectively treat internal hemorrhoids and varicose veins by injecting a specialized sclerosant solution directly into the affected tissue, causing it to shrink and collapse for lasting relief from bleeding, swelling, and discomfort. We ensure accurate diagnosis, personalized treatment planning, and comprehensive post-procedure care for a safe and smooth recovery. With expert vascular and proctological care and affordable pricing, our Sclerotherapy cost is suitable for patients seeking high-quality, minimally invasive treatment in Lucknow, India.

To seek an Expert Consultation for Sclerotherapy in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

Request a Call Back