Comparison of rubber band ligation and sclerosant injection for first and second degree haemorrhoids-- a prospective clinical trial

Abstract

Fifty patients with first or mild second degree haemorrhoids were randomly allocated to sclerosant injection (26) or rubber band ligation (24). One year after treatment 24 injection and 22 rubber band ligation patients were assessed. All patients presented with rectal bleeding; injection relieved 14 and rubber band ligation relieved 17 of this symptom (N.S.). Three of seven patients with prolapsing haemorrhoids who had sclerosant injections and five of seven who had rubber band ligation were relieved of this prolapse. However, a further six patients in the injection group developed prolapse for the first time during the one year follow-up period (p less than 0.05). Rubber band ligation relieved anal pain in 10 out of 14 patients whereas injection relieved only one patient of this symptom (p less than 0.05). Neither treatment influenced pruritus ani or faecal soiling. Although rubber band ligation caused more treatment discomfort, it is an effective management for first and mild second degree haemorrhoids and it should be considered as the procedure of choice.