COMPARISON OF FOAM POLIDOCANOL AND LIQUID POLIDOCANOL SCLEROTHERAPY IN TREATMENT OF GRADE II AND GRADE III HEMORRHOIDS IN A TERTIARY CARE HOSPITAL, SALEM

Abstract Introduction: Patients with hemorrhoids if not managed properly may have significant high morbidity. There is no literature available for comparing the outcomes of foam polidocanol with liquid polidocanol for treatment of grade 2 and 3 hemorrhoids and hence we are pursuing this study. Aim :To compare the efficacy of foam polidocanol to liquid Polidocanol sclerotherapy in treating symptomatic grade II and III hemorrhoidal disease. Methodology:68 patients volunteered for the study. Patient were randomized into liquid and foam group by using block randomization separately for grade 2 and 3 hemorrhoids. In Liquid group, 2ml of 3% polidocanol was injected at the base of hemorrhoids .In foam group 1ml of 3% polidocanol with 7 ml air was used to create foam immediately before injection .Sclerotherapy was done for both groups (maximum of 2 sittings) and patients were followed up at week1,2 and 4 and findings based on bleeding , pain , perianal itching and reduction in hemorrhoid size was noted at each follow up. Results: There is significant lesser amount of sclerosant used in foam with mean sclerosant injected in ml is 2.06 and 1.44 (p value - 0.002) in liquid and foam group respectively in grade 2 hemorrhoids and 2.88 and 1.50 (p value-0.001) in liquid and foam in grade 3 hemorrhoids respectively. Foam group had lesser incidence of peri-anal itching than liquid group at week 1 (p value-0.04) for grade 2 hemorrhoids but in further weeks it is not significant. Conclusion :Foam sclerotherapy and liquid sclerotherapy with 3% polidocanol have equal efficacy at week 4 of sclerotherapy.In Foam sclerotherapy significantly lesser sclerosant was needed to be injected there by subjecting the patients to lesser risk of local complications