Comparative Efficacy and Clinical Outcomes of 5% Phenol in Almond Oil versus 3% Sodium Tetradecyl Sulphate for the Sclerotherapy of Grade I and II Hemorrhoids: A Prospective Comparative Interventional Study
Efficacy and Clinical Outcomes of 5% Phenol in Almond Oil versus 3% Sodium Tetradecyl Sulphate for the Sclerotherapy of Grade I and II Hemorrhoids
Keywords:
Hemorrhoids, Injection sclerotherapy, Sodium tetradecyl sulphate, Proctology
Abstract
Background: Injection sclerotherapy is an established minimally invasive treatment for Grade I and II internal hemorrhoids. This study compared 5% phenol in almond oil with 3% sodium tetradecyl sulphate (STS), focusing on the timing of symptomatic recovery and safety.
Subjects and Methods: A prospective interventional study was conducted at TMMC&RC, Moradabad, from June 2024 to December 2025. Sixty patients with Grade I or II internal hemorrhoids were allocated into two groups of 30. Patients received either 5% phenol in almond oil or 3% STS and were assessed at Weeks 1, 3, 6, 12 and 18. Symptomatic recovery was the principal outcome.
Results: At Week 1, 19/30 (63.3%) patients in the phenol group had recovered compared with 0/30 in the STS group (p<0.001). By Week 3, 11 of the 12 phenol patients remaining under follow-up had recovered; no STS patient had recovered. STS showed progressive recovery thereafter: 10/30 (33.3%) at Week 6, 9/20 (45%) at Week 12 and 10/11 (90.9%) at Week 18. One STS patient (9.09%) remained unrecovered. No major procedure-related complications were documented. Conclusion: Phenol in almond oil produced a substantially faster early symptomatic response, whereas STS showed a delayed but progressive response. Both agents were well tolerated in this study, and sclerosant selection may be individualized according to the desired speed of symptom relief and feasibility of follow-up.
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References
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23. Moser KH, Mosch C, Walgenbach M, Bussen DG, Kirsch J, Joos AK, et al. Efficacy and safety of sclerotherapy with polidocanol foam in comparison with fluid sclerosant in the treatment of first-grade haemorrhoidal disease: A randomised, controlled, single-blind, multicentre trial. Int J Colorectal Dis. 2013;28:1439–47
24. Sankhala S, Sankhala S. Colonoscopic Sclerotherapy in the management of active internal hemorrhoidal bleeding: A retrospective study of 100 cases during 3 years. New Indian Journal of Surgery. 2018;9:505–6.
25. Alvi TH, Jamil S, Yaqoob N, Zubair M, Zulqurnain M. Comparison of Almond Oil Plus Phenol and Sodium Tetradecyl Sulfate for Rectal Prolapse in Children. Pakistan Journal of Medical and Health Sciences. 2023;17:465–7.
26. Cabrera Garrido J, López González G. Effective non-surgical treatment of hemorrhoids with sclerosing foam and novel injection device. Gastroenterology and Endoscopy. 2024;2:176–80.
2. Brisinda G. How to treat haemorrhoids. Prevention is best; haemorrhoidectomy needs skilled operators. BMJ. 2000;321:582–3.
3. Devi V, Deswal G, Dass R, Chopra B, Kriplani P, Grewal AS, et al. Hemorrhoid Disease: A Review on Treatment, Clinical Research and Patent Data. Infect Disord Drug Targets. 2023;23:15–35.
4. Kalkdijk J, Broens P, Ten Broek R, Van Der Heijden J, Trzpis M, Pierie JP, et al. Functional constipation in patients with hemorrhoids: A systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2022;34:813–22.
5. Warusavitarne J, Phillips RKS. Hemorrhoids throughout history-a historical perspective. Semin Colon Rectal Surg. 2007;18:140–6.
6. Liang Y, Ren T, Li R, Yu Z, Wang Y, Zhang X, Qin Z, Li J, Hu J, Luo C. Natural Products with Potential Effects on Hemorrhoids: A Review. Molecules. 2024 Jun 5;29(11):2673
7. Ji X, Huang J, Li Z, Luan X, Bai S, Zhu Z. Revealing the Molecular Mechanism of Sageretia theezans in the Treatment of Hemorrhoids based on Network Pharmacology. Comb Chem High Throughput Screen. 2024;28:1832–43.
8. Docter D, van Braak H, de Jong B, Gorter RR, Benninga MA, de Jong JR. Pediatric external hemorrhoids: clinical characteristics and outcomes of conservative treatment versus injection sclerotherapy. Eur J Pediatr. 2025 Aug 14;184(9):552.
9. Yu JH, Huang XW, Wu ZJ, Lin HZ, Zheng FW. Clinical study of use of large C suture in procedure for prolapse and hemorrhoids for treatment of mixed hemorrhoids. J Int Med Res. 2021 Mar;49(3):300060521997325
10. Groshilin VS, Shvetsov VK, Kolesnichenko AA, Alnikin AB, Sultanmuradov MI, Bardakhchyan VE, et al. Treatment of acute hemorrhoids according to the results of a multicenter observational study. Pirogov Russian Journal of Surgery. 2025;(3):112-23
11. Kodilinye SM, Kalloo AN. Endoscopic approaches to the management of hemorrhoids. Curr Opin Gastroenterol. 2023;39:375–80.
12. Aguilar-Alvarado MY, Baker B, Chiu LS, Shah MK. Benign Colorectal Disorders. Primary Care - Clinics in Office Practice. 2023;50:461–80.
13. Cabrera Garrido J, López González G. Effective non-surgical treatment of hemorrhoids with sclerosing foam and novel injection device. Gastroenterology and Endoscopy. 2024;2:176–80.
14. Paikos D, Gatopoulou A, Moschos J, Koulaouzidis A, Bhat S, Tzilves D et al. Banding hemorrhoids using the O’Regan Disposable Bander. Single center experience. J Gastrointestin Liver Dis. 2007;16:163–5.
15. Gallo G, Laforgia R, Goglia M, Lobascio P. Sclerotherapy with 3% polidocanol foam for the treatment of mucocutaneous bridges and/or residual piles after open excisional hemorrhoidectomy. Updates Surg. 2024;
16. Zhang YY, Hu B. Endoscopic polidocanol foam sclerobanding for the treatment of Grade II-III internal hemorrhoids: The focus of clinical practice. World J Gastroenterol. 2024;30:4246–8.
17. Khan N, Malik MAN. Injection sclerotherapy versus electrocoagulation in the management outcome of early haemorrhoids. J Pak Med Assoc. 2006;56:579–82.
18. Qu CY, Zhang FY, Zhang Y, Li MM, Li ZH, Cai MH, et al. Endoscopic polidocanol foam sclerobanding for the treatment of grade II-III internal hemorrhoids: A prospective, multi-center, randomized study. World J Gastroenterol. 2024;30:3326–35.
19. Singh Walia D, Singla A, Singh K, Kaur P. To Compare the Effectiveness of 20% Hypertonic Saline Versus 5% Phenol in Almond Oil as a Sclerosing Agent in Grade 1 and 2 Hemorrhoids. World J Surg Surgical Res. 2019;1104–9.
20. Kaidar-Person O Person B WSD. Hemorrhoidal disease: A comprehensive review. J Am Coll Surg. 2007;204:102–17.
21. Yano T YK. Comparison of Injection Sclerotherapy Between 5% Phenol in Almond Oil and Aluminum Potassium Sulfate and Tannic Acid for Grade 3 Hemorrhoids. Ann Coloproctol. 2015;31:103–5.
22. de Parades V, Aubert M, Fathallah N, Alam AA, Spindler L, Benfredj P. The comeback of hemorrhoidal sclerotherapy? Tech Coloproctol. 2022;26:599–601.
23. Moser KH, Mosch C, Walgenbach M, Bussen DG, Kirsch J, Joos AK, et al. Efficacy and safety of sclerotherapy with polidocanol foam in comparison with fluid sclerosant in the treatment of first-grade haemorrhoidal disease: A randomised, controlled, single-blind, multicentre trial. Int J Colorectal Dis. 2013;28:1439–47
24. Sankhala S, Sankhala S. Colonoscopic Sclerotherapy in the management of active internal hemorrhoidal bleeding: A retrospective study of 100 cases during 3 years. New Indian Journal of Surgery. 2018;9:505–6.
25. Alvi TH, Jamil S, Yaqoob N, Zubair M, Zulqurnain M. Comparison of Almond Oil Plus Phenol and Sodium Tetradecyl Sulfate for Rectal Prolapse in Children. Pakistan Journal of Medical and Health Sciences. 2023;17:465–7.
26. Cabrera Garrido J, López González G. Effective non-surgical treatment of hemorrhoids with sclerosing foam and novel injection device. Gastroenterology and Endoscopy. 2024;2:176–80.
Published
2026-03-30
How to Cite
Saini, D. K., Singh, A., & Jain, S. (2026). Comparative Efficacy and Clinical Outcomes of 5% Phenol in Almond Oil versus 3% Sodium Tetradecyl Sulphate for the Sclerotherapy of Grade I and II Hemorrhoids: A Prospective Comparative Interventional Study. Asian Journal of Medical Research, 15(1), 15-18. Retrieved from https://aijournals.com/index.php/ajmr/article/view/2721
Section
Surgery
