Hemorrhoid Clinic: Management and Treatment
Our hemorrhoid clinic offers diagnostic and treatment modalities for patients with hemorrhoids or suspected hemorrhoids. In the clinic, exam by anoscopy is conducted on all patients. For those with clinically significant internal hemorrhoids, rubber band ligation and infrared coagulation can be used in the office to eradicate hemorrhoids.
Rubber Band Ligation
Rubber band ligation uses a single-use, disposable device to suction hemorrhoidal tissue into the device and deploy a rubber band around the tissue. This reduces blood flow into the hemorrhoid, causing it to shrink. After the banded tissue falls off, the area heals with scar tissue the reduces the likelihood of recurrence, and prevents prolapse.
Of note, rubber band ligation can treat one column of hemorrhoids at a time, and thus may require up to three visits to band the three columns of hemorrhoidal veins. Treatments are usually spaced two weeks apart.
Infrared Coagulation (IRC)
IRC is performed under direct visualization of the internal hemorrhoids using an anoscope. IRC can treat all three hemorrhoidal columns at the same visit, although occasional retreatment at the 2–4-week follow-up visit is required if shrinkage is inadequate or symptoms continue.
In addition to the ability to treat all three columns of hemorrhoids at the same time, IRC may be favored in pregnant women and patients on chronic anticoagulation or antiplatelet therapies
