Internal piles
Advantages:
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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