Treatment may be surgical or nonsurgical. Most of the various nonsurgical procedures currently available are performed in the clinic or as outpatient surgery. Grade II or III requires symptomatic treatment using banding or any other nonsurgical procedure. Grade III and IV present with severe symptoms. Patient presents with additional anorectal conditions requiring surgery.
Patient indicates preference following surgery consultation.
A band ligature is passed through an anoscope and placed on the rectal mucosa above the dentate line. Tissue eventually sloughs off in a week and leaves an ulcer that becomes fibrotic. Infrared coagulation serves best for Grade I, II, and some Grade III cases. It is as effective as banding and with fewer and less severe complications. Light energy coagulates the hemorrhoid tissue.