The following is ideal for the treatment with injection of sclerosing agents

It is ideal for first-degree internal hemorrhoids which bleed and for early second-degree internal hemorrhoids, injecting sclerosant will produce fibrosis in the submucosal region (sclerosis leading to mucosal fixation on to deeper planes and occlusion of lakes) thereby fixes the cushion which does not prolapse, causes strengthening of the vessel wall and obliteration of the vessel lumen it is done on op basis and gives 95% cure rate in the first-degree prolapse , it&;s a painless procedure and results are quick for prolapsed piles stapled haemorrhoidectomy is preferred, for external piles excision is done, for strangulated haemorrhoidectomy conservative management by sitz bath after 5days haemorrhoidectomy is done Reference SRB edition 5 page no. 972,974,976