Haemmerhoids sclerotherapy question
Discussion
Hi guys,
I was diagnosed with grade 2-3 internal haemmerhoids a week ago. Today, I just got back from a sigmoidoscopy (which my specialist wanted me to have to make an accurate diagnosis.
Anyway, the sigmoidoscopy found nothing so my specialist is convinced that the bleeding (which stopped before I had my consultation a week ago) is indeed from haemmerhoids.
Question I have, is I had the injection treatment and I felt the standard pinch that you get from an injection, but everywhere I read says there should be no pain from the injection unless the wrong site was injected?
Thanks|
I was diagnosed with grade 2-3 internal haemmerhoids a week ago. Today, I just got back from a sigmoidoscopy (which my specialist wanted me to have to make an accurate diagnosis.
Anyway, the sigmoidoscopy found nothing so my specialist is convinced that the bleeding (which stopped before I had my consultation a week ago) is indeed from haemmerhoids.
Question I have, is I had the injection treatment and I felt the standard pinch that you get from an injection, but everywhere I read says there should be no pain from the injection unless the wrong site was injected?
Thanks|
OK, quick anatomy lesson.
In the anal canal, there is a thing called the pectinate line (a.k.a. dentate line). It's about 1/3 of the way in and the other 2/3 of the canal lie above it.
The short answer is that a haemorrhoid that's north of the line will be painless, it would be classified as an internal haemorrhoid . One south of the line is considered external and is innervated, i.e., you can feel it as a grape of wrath.
Here's an online diagram to clarify...
http://en.wikipedia.org/wiki/Pectinate_line#/media...
If you felt pain, it suggests that the line was crossed during the treatment.
NB: I researched this before going in for treatment of a fissure in ano.
In the anal canal, there is a thing called the pectinate line (a.k.a. dentate line). It's about 1/3 of the way in and the other 2/3 of the canal lie above it.
The short answer is that a haemorrhoid that's north of the line will be painless, it would be classified as an internal haemorrhoid . One south of the line is considered external and is innervated, i.e., you can feel it as a grape of wrath.
Here's an online diagram to clarify...
http://en.wikipedia.org/wiki/Pectinate_line#/media...
If you felt pain, it suggests that the line was crossed during the treatment.
NB: I researched this before going in for treatment of a fissure in ano.
If you'll permit, I can butt in here too - if you'll pardon the expression. I had two flexible sigmoidoscopies and a full-fat colonoscopy, from which it was determined that I had 'indeterminate colitis. This translates to..."Errr, your bowel is inflamed but we don't know why".
Right, eyes down for a flexible sig.
Step one: strip off and put on the usual, tie-in-the-back, peek-a-boo hospital gown. I kept my jocks on anyway and they didn't mind but your dignity's out of the window in any case.
Step two: Lie on your side, knees up and bear nursie putting a squeezy bottle up your fundament. Thrill to the feeling of soapy enema stuff filling the last bit of your colon. Hold for 5 mins, walk carefully to the potty and open the floodgates. Now you're empty and ready for your screen test.
Step three: In the imaging room, lie on the couch as you did for the enema. Gas and air mix may be offered - accept if you're at all nervous but if you do accept, be prepared to feel a bit dizzy and to stay a bit longer in the ward afterwards.
Step four: Watch in fascination at a plop's eye view (in reverse) of your tailpipe and back box. The feeling is a little strange but there's no pain. If biopsies are taken (as is usual), it'll feel odder still. A little jaw comes out of the endoscope, grabs what they're after and rips it out. You wince but, as your bowel has no nerves, there's noting to feel.
It's common practice to inflate you internally. This again feels weird but, apart from a bit of gaseous discomfort (think turbocharged baked beans) it isn't a problem.
Step four: Relax as the cameraman (or woman) withdraws the 'scope. You'll then be wheeled back to the ward, although if the inflation job was comprehensive, they won't really need to wheel - just steer your jet propelled trolley.
I jest but trust me - it's a painless procedure. The flexible sigmoidoscope goes as far as the start of your descending colon - or just around the corner into your transverse colon. The tube is slender (about little finger thickness) and loads of lube is used.
I'm sufficiently lucky as to have escaped a cytoscopy thus far but I imagine it would be a lot worse. Even a full colonoscopy isn't so bad, but for the starvation and the thermonuclear quality laxative the night before.
All the best with it.
Right, eyes down for a flexible sig.
Step one: strip off and put on the usual, tie-in-the-back, peek-a-boo hospital gown. I kept my jocks on anyway and they didn't mind but your dignity's out of the window in any case.
Step two: Lie on your side, knees up and bear nursie putting a squeezy bottle up your fundament. Thrill to the feeling of soapy enema stuff filling the last bit of your colon. Hold for 5 mins, walk carefully to the potty and open the floodgates. Now you're empty and ready for your screen test.
Step three: In the imaging room, lie on the couch as you did for the enema. Gas and air mix may be offered - accept if you're at all nervous but if you do accept, be prepared to feel a bit dizzy and to stay a bit longer in the ward afterwards.
Step four: Watch in fascination at a plop's eye view (in reverse) of your tailpipe and back box. The feeling is a little strange but there's no pain. If biopsies are taken (as is usual), it'll feel odder still. A little jaw comes out of the endoscope, grabs what they're after and rips it out. You wince but, as your bowel has no nerves, there's noting to feel.
It's common practice to inflate you internally. This again feels weird but, apart from a bit of gaseous discomfort (think turbocharged baked beans) it isn't a problem.
Step four: Relax as the cameraman (or woman) withdraws the 'scope. You'll then be wheeled back to the ward, although if the inflation job was comprehensive, they won't really need to wheel - just steer your jet propelled trolley.
I jest but trust me - it's a painless procedure. The flexible sigmoidoscope goes as far as the start of your descending colon - or just around the corner into your transverse colon. The tube is slender (about little finger thickness) and loads of lube is used.
I'm sufficiently lucky as to have escaped a cytoscopy thus far but I imagine it would be a lot worse. Even a full colonoscopy isn't so bad, but for the starvation and the thermonuclear quality laxative the night before.
All the best with it.
T5SOR said:
Thanks for the info Davill.
What symptoms did you have leading up to it?
Glad to be of help. What symptoms did you have leading up to it?
It was essentially unreliable digestion. I'd get episodes of what acted like intolerance to certain foods but it was entirely random...there was no correlation between specific foods and the problems.
Subjectively, I'd have periods of overproductive bowel activity, as though I had a bug. However, blood and stool samples showed nothing awry. I'd have cramps, colic-like pains, excessive wind and seriously spectacular night sweats.
I also had occasional bleeding...this was before the fissure happened but it was bright, red blood in the pan. The stool sample showed no occult (hidden) blood coming from higher up. The biopsies (total of eight from the three investigations) were also clear. But my large intestine was very rough and scabby inside.
The treatment was few months on Mesalazine tablets. This settled things down pretty quickly and it's been OK for about a year now. The fissure is a separate issue.
T5SOR said:
I have a Sigmoidoscopy in 2 weeks. How was it? I am hoping it feels better than a Cystoscopy!
What other symptoms have you had? I think mine is IBS.
Hi mate, did not expect this thread to take off! It went really well. I was sedated and had entonox which helped. It all happened so quickly. Not sure if that is the skill of the consultant or the drugs impact, or both. What other symptoms have you had? I think mine is IBS.
I don't have IBD/Crohn's but unfortunately some people with it say this is very painful (but it's very subjective!) you should be good. I'd always recommend that you take all the drugs you can get because moving can possibly cause the camera to damage your intestines and if you can't cope with the pain when not using any drugs, they may not be able to administer drugs mid-way. You don't want an inconclusive surgery as you may need to have it again and tha will be terrible.
Are you going private? Good luck!
Glad it went well Z.
I can now tell you what happened at the end of my first flexible sig - I kept it to myself before so as to not spook you.
I had a newbie girl to carry out the procedure. No problems during the tracking shots in and out. However, she couldn't get the 'scope to come out of my starfish. After a bit of tugging, I heard the (presumably) experienced operator who was supervising saying something about straightening out the 'scope. Rookie mistake, obviously.
I nevertheless felt no pain at all and didn't have any drugs. However, you're quite right about keeping still. A tear in the bowel wall would be very bad news and a quick ticket to an emergency op because of the risk of peritonitis. I'd been warned of this (it's a very small risk) before signing the permission document.
I can now tell you what happened at the end of my first flexible sig - I kept it to myself before so as to not spook you.
I had a newbie girl to carry out the procedure. No problems during the tracking shots in and out. However, she couldn't get the 'scope to come out of my starfish. After a bit of tugging, I heard the (presumably) experienced operator who was supervising saying something about straightening out the 'scope. Rookie mistake, obviously.
I nevertheless felt no pain at all and didn't have any drugs. However, you're quite right about keeping still. A tear in the bowel wall would be very bad news and a quick ticket to an emergency op because of the risk of peritonitis. I'd been warned of this (it's a very small risk) before signing the permission document.
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