Hemorrhoidal Disease is recognized as one of the most common medical conditions in general population, especially in people with high standard living conditions. It is estimated that in western countries about 5% of population is affected by hemorrhoidal disease, with a higher frequency in subjects aged between 40-60, especially females (after pregnancy and childbirth). Predisposing factors are prolonged orthostatism, sedentary lifestyle, obesity, an improper diet ,   constipation, some sports (cycling, horse riding, body building).

Despite the development through the years of several techniques to treat hemorroidal disease (surgery, band ligation, laser etc), no outpatient, painless and effective technique had been identified. Now, foam sclerotherapy with flexible endoscope meets these criteria. 

The physiopathological CONCEPT of the foam sclerotherapy procedure is to induce an inflammatory reaction (principle derived from the phelobological treatment of varicose veins in lower limbs) and to induce a vasospasm, thus reducing hemorroidal prolapse and bleeding. 

The procedure requires no anesthesia and uses a flexible endoscope; as the foam is injected in a site with no sensitive innervation, the injecting procedure results painless: the goal of accessing the hemorroidal plexus via endoscope rather than directly punctured it is indeed to better identify the area known as pectinate line where there is no innervation. At the end of the treatment, the patient will be able to perform his/her everyday activities as usual. Usually 2 or 3 sessions are needed, according to the severity of the disease.

According to our clinical experience of more than 500 subjects treated, from the analyis of  surveys administered , the procedure seems to be well tolerated; especially appreciated by the patients resulted the absence of pain -during and after the treatment- and the easy return to daily activities. The validity analysis SCORE has revealed a statistically significant difference concerning the rate of bleeding, the pain scale and the discomfort reported by patients before and after the procedure. The hemorroidal foam endosclerosis represents a mini-invasive approach leading to optimal results with mid to late-term resolution of symptoms and, mostly, granting patients’satisfaction, thanks to to the painfree techinque which allows the subject to rapidly return to his/her everyday activities.