Office Treatments

Rubber band ligation of hemorrhoids

  • Most common office procedure
  • Band placed using special instruments. Must be placed high in the anal canal or severe pain will result
  • Band draws excess mucosa at the top of hemorrhoid, causes scar & fixation of lining of anal canal to prevent prolapse.

In one study on rubberband ligation there were 240 patients. The patients were followed for 32 months. Results based on grade of hemorrhoids:

  • Grade 1 – 100 % success rate
  • Grade 2 – 97% success rate
  • Grade 3 – 69% success rate
  • Grade 4 – 0% success rate

Another study showed there are better results & no difference in complications with multiple bands vs. one band

Complications of rubberband ligation:

  • Delayed hemorrhage: 1% at 1-2 weeks
  • Thrombosis of external hemorrhoids: 3%
  • Rectal tenesmus or spasm: 11%
  • Mild anal pain 7.4% (esp. with multiple bands)
  • Dysuria: 4.3%
  • Transient anal bleeding: 3.7%, usually 5-7days
  • Rectal sepsis or major infection: Rare

Patient information on rubber band ligation of hemorrhoids:

Infrared coagulation (IRC): Infrared coagulation treatment of hemorrhoids is a less invasive, less painful treatment for internal hemorrhoids. Infrared light is applied to the base of the hemorrhoid, causing the blood vessel which supplies the hemorrhoid to coagulate and thus dry up, and the hemorrhoid recedes.

  • Can be an office procedure
  • Regaining popularity
  • No anesthesia is needed in most cases
  • Infrared radiation coagulates or burns tissue protein
  • Destruction of the hemorrhoids depends on intensity & duration of treatment
  • Decreases hemorrhoidal blood flow by coagulating the blood vessels feeding the hemorrhoids
  • Does not treat excess redundant tissue
  • Requires more treatments than rubberband ligation and less painful than rubberband ligation

Patient information on IRC:

Bipolar diathermy: Diathermy is the use of high frequency electric current to produce heat.

  • Electrical energy is used to coagulate the hemorrhoidal tissue and the feeding blood vessel.
  • Useful for small, internal hemorrhoids
  • Performed above the level of the nerves
  • Less painful than most techniques
  • Can be performed in the doctor’s office
  • May require multiple treatments