Internal piles


1. No hospitalisation

2. No anaesthetic

3. Minimal pain

4. Minimal time off work

5. Cost effective

6. Easily repeatable

*Ref: S. Brown, Haemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree haemorrhoids (HubBLe): a multicentre, open-label, randomised controlled trial, Lancet. 2016 Jul 23; 388(10042): 356–364.

Rubber band ligation

This is a simple office based treatment, typically recommended for the first line treatment of the internal piles. 

No anaesthetic is required and you are able to go home almost immediately.

This is a procedure in which elastic bands are applied onto an internal haemorrhoid at least 1 cm above the dentate line to cut off its blood supply. 

Within 5–7 days, the withered haemorrhoid falls off. Cure rate has been found to be about 87%.

Recently it was shown that the series of rubber band ligation is equally effective than the methods using advanced technology (like Laser, radiofrequency, etc.), but costs the friction of it.*


Possible disadvantages:

1. May require more than one course of treatment

2. Does not deal with external skin tags and loose skin of haemorrhoids

3. There is a small risk of complications such as aggravation of other haemorrhoids, bleeding, pain or infection.  The pain is difficult to predict and is usually not severe.  There is a bearing down sensation sometimes and Paracetamol taken after the procedure is helpful.

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