A prospective study of infrared coagulation, injection and rubber band ligation in the treatment of haemorrhoids

  • A. J. Walker
  • R. J. Leicester
  • R. J. Nicholls
  • C. V. Mann
Original Articles


One hundred patients with non-prolapsing and one hundred with prolapsing haemorrhoids were allocated to receive conventional treatment (CT) by injection sclerotherapy or rubber band ligation, or infrared photocoagulation (IRC). Significantly more patients with nonprolapsing haemorrhoids were symptom free after IRC (81%) than CT (59%) at three months. (Chi2=4.4, p=0.05). There was no significant difference in the outcome at 1 or 4 years. Likewise for prolapsing haemorrhoids, there was no significant difference in the outcome of IRC or CT at 3 months, one or 4 years. However, recurrence of prolapse was more common after IRC (54%) than rubber band ligation (RBL) (27%) at 1 year (Chi2=3.46, p<0.1). IRC was significantly less painful than CT (p<0.001). IRC is a safe, rapid, non-invasive alternative to CT, which is acceptable to the patient and give similar results, though RBL provides more rapid and longer lasting relief from prolapse.


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  1. 1.
    Leicester RJ (1981) Out-patient treatment of haemorrhoids. J Roy Nav Med Serv 67:23–25Google Scholar
  2. 2.
    Murie JA, Sim AJW, MacKenzie K (1982) Rubber band ligation versus haemorrhoidectomy for prolapsing haemorrhoids — a long term prospective clinical trial. Br J Sur 69:536–538Google Scholar
  3. 3.
    Neiger A, Moritz K, Keifhaber P (1978) Haemorrhoiden-Verödungsbehandlung durch Infrarotkoagulation. In Henning H (ed) Fortschritte der gastroenterologischen Endoskopie. Witsrock, Baden-Baden, pp 102–106Google Scholar
  4. 4.
    Goligher JC (1984) Surgery of the anus, rectum and colon, 5th edn. Balliere-Tindall, London, pp 108–113Google Scholar
  5. 5.
    Mann CV, Motson R, Clifton M (1988) The immediate response to injection therapy for first degree haemorrhoids. J R Soc Med 81:146–148Google Scholar
  6. 6.
    Groves AR, Evans JC, Alexander-Williams J (1979) Management of internal haemorrhoids by rubber band ligation. Br J Surg 58:923–924Google Scholar
  7. 7.
    Leicester RJ, Nicholls RJ, Mann CV (1981) Infrared coagulation: a new treatment of haemorrhoids. Dis Col Rect 24:602–605Google Scholar
  8. 8.
    Thomson WHF (1975) The nature of haemorrhoids. Br J Surg 62:542–552Google Scholar
  9. 9.
    Ambrose NS, Morris D, Alexander-Williams J, Keighley MRB (1985) A randomised trial of photocoagulation or injection clerotherapy for the treatment of first- and second-degree hemorrhoids. Dis Col Rect 28:238–240Google Scholar
  10. 10.
    Ambrose NS, Hares MM, Alexander-Williams J, Keighley MRB (1983) Prospective randomised comparison of photocoagulation and rubber band ligation in treatment of haemorrhoids. Br Med J 286:1389–1391Google Scholar
  11. 11.
    Templeton JL, Spence RAJ, Kennedy TL, Parks TG, MacKenzie G, Hanna WA (1983) Comparison of infrared coagulation and rubber band ligation for first and second degree haemorrhoids: a randomised prospective clinicical trial. Br Med J 286:1387–1389Google Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • A. J. Walker
    • 1
  • R. J. Leicester
    • 1
  • R. J. Nicholls
    • 2
  • C. V. Mann
    • 2
  1. 1.Royal Naval Hospital HaslarGosportUK
  2. 2.St. Mark's HospitalLondonUK

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