If you've had a minimally invasive treatment for hemorrhoids, you probably want to know if they're likely to come back. A new study followed patients with mild internal hemorrhoids who received foam sclerotherapy—a procedure where a special foam is injected to shrink the swollen veins. Over three years, the cumulative recurrence rate reached 20%. That means for a group of people who had this treatment, one in five experienced a return of their symptoms by the three-year mark.
The researchers developed a tool called the Endoscopic Hemorrhoid Recurrence Score (Endo-HRS) to try to predict this risk. It looks at four simple things doctors can see during an endoscopy: the number of hemorrhoids, their largest diameter, a 'red color sign' on the surface, and the patient's sex. In their analysis, this score did a good job of sorting patients into different risk categories. They also looked at tissue from hemorrhoids that came back and found changes in tiny blood vessels and the surrounding tissue structure.
It's important to understand what this study is and isn't. This was an observational look back at patient records, which means it can show patterns and associations, but it can't prove the score itself causes a change in outcome. The researchers themselves point out several limitations: the scoring model hasn't been adjusted for different populations, it may not apply to all hospitals or patient groups, and doctors might interpret the signs slightly differently. The tool showed promise in an initial validation with a separate group of patients, but it needs much more testing in real-world settings before doctors could confidently use it to guide decisions.
