A Comparison of Flexible Endoscopic Polidocanol Liquid and Foam Sclerotherapy in Cirrhotic Patients With Bleeding From Internal Hemorrhoids
Liver Cirrhosis, Internal Hemorrhoid
About this trial
This is an interventional treatment trial for Liver Cirrhosis
Eligibility Criteria
Inclusion Criteria: Cirrhotic/ACLF patients with ano-rectal bleeding, either ongoing or within last 1-week, judged to be hemorrhoidal in origin based on clinical features and endoscopy evaluation. Exclusion Criteria: Coagulopathy threshold of INR >2.0 and/or platelet count <50,000/mm3. Antiplatelet or anticoagulants use. Immunosuppressive medications (including steroids >20mg/d or equivalent for >2 weeks). Grade IV internal hemorrhoids. Thrombosed or strangulated IH or EH. Previous EST or RBL in last 1-year. Co-existing ano-rectal diseases like perianal abscess, stricture, fistula, anal malignancies, ano-rectal stenosis, radiation proctitis, or proctitis. Patients not capable of understanding and signing the informed consent. Pregnancy. Bronchial Asthma.
Sites / Locations
- Institute of Liver & Biliary Sciences (ILBS)
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Sclerotherapy with 1.5% polidocanol.
Foam sclerotherapy
2mL (3%) polidocanol = 60mg; maximal dose: 1mL/column and 4mL/session.
Tessari's technique; 4mL 3% poilidocanol +16mL air; maximal dose: 2mL/column and 20mL/session.