Investigating the Follow-up Period after ALTA Sclerotherapy Using Transanal Ultrasonography.

OBJECTIVES

This study aims to clarify the appropriate follow-up period after aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy for internal hemorrhoids by transanal ultrasonography.

METHODS

Forty-four patients (98 lesions) who underwent ALTA sclerotherapy were analyzed. Transanal ultrasonography was performed pre and post-ALTA sclerotherapy to observe the thickness and the internal echo image of hemorrhoid tissue. Patients who developed complications were excluded.

RESULTS

No recurrence in 12 months was observed in 44 patients. After 1-3 months of ALTA sclerotherapy, hemorrhoids were observed in the low-echo imaging region. During this period, hemorrhoidal tissue was observed thickest by granulation. Moreover, hemorrhoid tissue contracted by fibrosis formed 5-7 months post-ALTA sclerotherapy, with a thinner hemorrhoid. Furthermore, hemorrhoids hardened and regressed with intense fibrosis 12-months after the therapy and eventually became thinner than pre-ALTA sclerotherapy.

CONCLUSIONS

After ALTA sclerotherapy, the suggested follow-up period with and without the development of complications is ～6 and ～3 months, respectively.