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

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 less than 0.1). IRC was significantly less painful than CT (p less than 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.