Injectable therapies are non-surgical, minimally invasive treatments used to shrink internal hemorrhoids by injecting special medical solutions into the swollen veins. These therapies are especially useful for early to moderate-stage piles (Grade I–III).
They are quick, nearly painless, and can be done in a doctor’s clinic without anesthesia.
1️⃣ Sclerotherapy (Most Common Injectable Therapy)
What it is:
A medical solution (called a sclerosant) is injected directly into the hemorrhoidal tissue.
This solution causes controlled inflammation, which then leads to shrinking and hardening of the hemorrhoid.
How it works:
- The injection closes the blood vessels supplying the hemorrhoid
- The hemorrhoid shrinks gradually
- It eventually dries up and disappears
Why it’s popular:
- Quick procedure (5–10 minutes)
- No cutting or stitches
- Minimal discomfort
- Ideal for people who fear surgery
- Safe for older patients or those on blood thinners (with caution)
Common sclerosants include:
- Polidocanol
- Phenol in almond oil
- Sodium tetradecyl sulfate
2️⃣ Foam Sclerotherapy (Newer Trend)
What it is:
A “foam version” of the sclerosant is injected, which spreads better inside the hemorrhoidal veins.
Benefits:
- More surface coverage
- Better absorption
- More precise action
- Higher success rate for multiple hemorrhoids
Foam sclerotherapy is becoming a preferred option in many hospitals due to better results compared to liquid injections.
3️⃣ Dextrose (Glucose) Injection Therapy
What it is:
A natural, mild sclerosant made from hypertonic dextrose (a form of sugar) is injected into the hemorrhoid.
Why it’s preferred for some patients:
- Very safe
- Minimal allergic reactions
- Good for people who cannot tolerate chemical sclerosants
Best for:
- Early-grade piles
- Sensitive patients
- Elderly patients
4️⃣ ALTA Therapy (Alum + Tannic Acid Injection)
What it is:
A four-step injection technique widely used in Japan and now spreading globally.
It uses aluminum potassium sulfate + tannic acid to shrink hemorrhoids.
Advantages:
- Strong shrinking effect
- Good for Grade II–III piles
- Long-lasting results
This therapy is becoming a trending option due to its high success rate in clinical studies.
5️⃣ Botulinum Toxin (Botox) Injection
What it is:
Botox is injected near the anal sphincter to relieve muscle spasm.
Why it’s used:
- Reduces severe pain
- Relieves anal tightness
- Helpful after hemorrhoid procedures
- Good for thrombosed or very painful hemorrhoids
It does not shrink hemorrhoids directly but helps with pain control and healing.
Benefits of Injectable Therapies
- No hospitalization
- Done in 5–10 minutes
- Very minimal pain
- No cuts, wounds, or stitches
- Low cost compared to laser or surgery
- Quick return to normal activities
- Good option for patients not fit for surgery
Limitations
Injectable therapies may be less effective for:
- Grade IV piles (large, permanently prolapsed)
- Very large external hemorrhoids
- Recurrent piles that need surgical correction
Who Is an Ideal Candidate?
You are most likely to benefit if you have:
- Bleeding hemorrhoids
- Internal piles (Grades I–III)
- Piles that do not prolapse much
- Mild to moderate pain
- Are elderly or avoid surgery