Alternatives in the treatment of hemorrhoidal disease.

Pain, bleeding, protrusion, soilage, itching, and burning are anorectal complaints associated with hemorrhoidal disease. Although hemorrhoidectomy remains the treatment of choice for grade 3 and 4 hemorrhoids, symptoms can be controlled short of hemorrhoidectomy, the alternative methods being effective in lesser degrees of involvement, such as grades 1, 2, and 3. Cryosurgery and dilation are fading alternatives; laser is becoming more widely used, but results have not been fully evaluated. Sclerotherapy, rubber band ligation, and infrared coagulation are also effective alternatives for patients who demand nonsurgical therapy.