INFRARED COAGULATION VERSUS RUBBER BAND LIGATION IN THE TREATMENT OF INTERNAL HAEMORRHOIDS – A RANDOMISED, PROSPECTIVE STUDY
Objective: The aim of the study was to compare the effectiveness, patient tolerance, need and complications of infrared coagulation (IRC) versus rubber band legation in the treatment of uncomplicated internal haemorrhoids.
Design: Randomised Control Trial.
Place and Duration of Study: Study was done at surgical outpatient department of Combined Military Hospital (CMH), Multan, from January 2001 to April 2002.
Patients and Methods: A total of 150 patients with uncomplicated internal haemorrhoids without any concomitant ano-rectal disease were randomized and treated by infrared coagulation (IRC ) or rubber band ligation (RBL ) in two groups (75 patients in each group). Infrared coagulation or RBL was performed in one or more session with four weeks interval until symptoms (bleeding and or prolapse) were resolved. Treatment outcome and complications were assessed by proctoscopy and questionnaire. Follow up was made at three months, six months and twelve months.
Results: Treatment outcome was assessed in 150 patients. For IRC 71 (94%) patients and for RBL 66 (88%) patients were symptom free after twelve months. Pain following treatment was more common and more severe after RBL than after IRC. Bleeding occurred in both IRC and RBL patient without any significance.
Conclusion: IRC and RBL were equally effective in the treatment of internal haemorrhoids. The rate and severity of pain was higher after rubber band ligation. Infrared coagulation should be the first line of treatment for haemorrhoids.