Foam sclerotherapy for haemorrhoids in Naples

Outpatient haemorrhoid sclerotherapy in Naples using sclerosant foam may be considered for some patients with symptomatic internal haemorrhoidal disease. It is recommended only after a medical assessment: rectal bleeding must not automatically be attributed to haemorrhoids without appropriate investigation.

Haemorrhoids are not simply “swollen veins”, but normal vascular cushions in the anal canal that can enlarge, bleed or prolapse. The choice between conservative treatment, sclerotherapy and other options depends on the symptoms, disease grade and individual patient characteristics.

When may haemorrhoid sclerotherapy in Naples be indicated?

Sclerotherapy may be considered particularly for symptomatic internal haemorrhoids, especially when bleeding is the main problem and conservative treatment alone does not provide adequate control. It may also be considered in some cases involving congestion, discomfort or prolapse, but it is not suitable for every form of haemorrhoidal disease.

• Bleeding during or after a bowel movement.
• Discomfort, itching, discharge or a feeling of anal pressure.
• Internal haemorrhoids that tend to prolapse.
• Persistent symptoms despite addressing constipation, bowel habits and diet.
• Recurrent symptoms after previous treatment, requiring individual reassessment.

Important: blood in the stool, anaemia, recent changes in bowel habit, weight loss or persistent pain require appropriate diagnostic investigation. The consultation also helps rule out fissures, fistulas, inflammation and other causes of bleeding.

How treatment with sclerosant foam is performed

During the procedure, the doctor injects a controlled amount of foam sclerosant into the internal haemorrhoidal tissue, at a site selected to minimise discomfort. The substance produces a controlled local reaction that helps reduce bleeding and the volume of the treated tissue.

The procedure is performed on an outpatient basis, involves no incisions or stitches and generally does not require general anaesthesia or hospital admission. It is usually well tolerated, but experiences vary from person to person: a completely pain-free or discomfort-free treatment cannot be promised.

Automated foam preparation with Varixio®

At Centro Medico Gargano, sclerosant foam is not prepared manually: we use Varixio®, an automated system for preparing microfoam. Much of the earlier research on haemorrhoid sclerotherapy used manual preparation, usually the Tessari method, in which sclerosant and gas are mixed between two syringes.

Varixio® automates mixing in a dedicated capsule and keeps the foam homogeneous during the procedure. Studies of its physical characteristics describe more uniform bubble size, greater stability and standardised preparation. The main technical advantage is reproducibility: variability associated with manual preparation and the operator is reduced, producing foam with more consistent characteristics.

The initial clinical evidence specific to haemorrhoids is encouraging. An observational study of 50 patients with grade II disease reported complete resolution of bleeding in 72% of patients after one week and 78% at three months, with no major complications. A subsequent retrospective study of 218 patients with grade I–IV haemorrhoids reported favourable results and a low recurrence rate during follow-up, again with no major complications.

What does this mean for the patient? Varixio® represents an important technical development in foam standardisation and may help make treatment more reproducible. However, randomised studies directly demonstrating superior clinical efficacy over manual preparation for haemorrhoids are not yet available. For transparency, we therefore do not promise guaranteed results: we assess the indication and response in each patient while the evidence on the automated system continues to develop.

Sources: study of the physical characteristics of automated foam; preliminary clinical study of 50 patients treated with Varixio®; 2025 study of 218 patients; systematic review of haemorrhoid sclerotherapy.

Why the first consultation is required

The first consultation establishes your medical history, assesses symptoms and determines whether sclerotherapy is appropriate. Where indicated, assessment may include inspection, digital rectal examination and anoscopy. It is also important to tell the doctor about anticoagulant or antiplatelet medication, allergies, pregnancy, bowel disease, previous operations and other relevant conditions.

No preparation is usually needed on the previous day: bowel preparation and fasting are not required for the first consultation or possible sclerotherapy unless the doctor advises otherwise. If, after the consultation, the doctor confirms that sclerotherapy is indicated, feasible and safe in your case, treatment may be performed at the same appointment, without necessarily returning on another day. This is assessed individually and cannot be guaranteed before the consultation. Do not stop medication on your own initiative.

If sclerotherapy is unsuitable, the available alternatives are discussed: medical treatment and lifestyle measures, rubber band ligation, proctological or surgical assessment, and further diagnostic investigations.

How many sessions may be needed?

One session may be sufficient for some patients; others may benefit from further treatment after clinical reassessment. Additional sessions are not automatic and are proposed only when needed. Full details of the care pathway and costs are available in the information PDF sent by email.

Haemorrhoidal disease can be chronic and recurrent. Sclerotherapy treats the current condition, but cannot guarantee that symptoms will not return in future years. A later recurrence requires a new assessment and should not be regarded as an unlimited “touch-up” included in the previous session.

Benefits and limitations of haemorrhoid sclerotherapy

• Minimally invasive outpatient treatment.
• No cuts or stitches.
• No hospital admission in most cases.
• Generally quick return to activities, following medical advice.
• Treatment can be repeated when clinically appropriate.
• Not suitable for every grade or type of haemorrhoidal disease.
• Results cannot be guaranteed and recurrence is possible.

Possible side effects

Like any medical procedure, sclerotherapy can cause side effects. Reported effects include local discomfort or pain, tenesmus (a persistent urge to pass stool), minor bleeding, inflammation, thrombosis, ulceration or urinary symptoms; more serious reactions are rare. Personalised instructions and symptoms requiring contact with the doctor are explained before and after treatment.

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Frequently asked questions

Can I book sclerotherapy directly?

You book the first consultation, which is essential to confirm the diagnosis and determine whether sclerotherapy is indicated. If the doctor considers treatment appropriate, feasible and safe during the consultation, sclerotherapy may be performed at the same appointment. This is assessed individually and is not guaranteed in advance.

Do I need to prepare before the consultation or sclerotherapy?

Usually not: bowel preparation or fasting on the previous day is not required unless the doctor advises otherwise. It is important to disclose current medication and not stop any medicine on your own initiative.

Where can I find the costs of treatment?

The first haemorrhoid consultation costs €150: you can book online and choose to pay online or directly at the practice. Full details of consultation, treatment session and follow-up costs are provided in the information PDF, which can be requested using the form on this page.

Is treatment painful?

It is generally well tolerated because the injection is given in the internal part of the anal canal, but sensitivity and the perception of discomfort vary. Complete absence of pain cannot be promised.

Can I return to my activities straight away?

Many patients resume normal activities quickly, but timing and restrictions depend on the clinical findings and the instructions given after the procedure.

Can haemorrhoids come back?

Yes. Haemorrhoidal disease may recur regardless of the treatment used. Regular bowel movements, fibre, hydration and avoiding straining help reduce contributing factors, but do not remove the risk entirely.

Scientific evidence

Sclerotherapy is included among outpatient treatments for haemorrhoidal disease in the American Society of Colon and Rectal Surgeons clinical practice guidelines. Clinical studies and systematic reviews have assessed the efficacy, safety, number of sessions and risk of recurrence with polidocanol foam: randomised study, systematic review and meta-analysis and three-year multicentre follow-up.

First consultation for haemorrhoid sclerotherapy in Naples

Centro Medico Gargano is located at Via Marchese Giuseppe Palmieri 71, Naples. The first consultation is required to determine whether sclerotherapy is indicated. First haemorrhoid consultation: €150. Book online and choose your day and time. You can pay online or directly at the practice.