Download PDF
CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2013; 04(01): 006-009
DOI: 10.1055/s-0039-1700261
Original Article
Society of Gastrointestinal Endoscopy of India

Colonoscopic band ligation for internal hemorrhoids - A tertiary care experience

Umesh Jalihal
Department of Gastroenterology, M.S. Ramaiah Memorial Hospitals, Bangalore – Karnataka
,
Satya Prakash B S.
Department of Gastroenterology, M.S. Ramaiah Memorial Hospitals, Bangalore – Karnataka
,
Avinash B.
Department of Gastroenterology, M.S. Ramaiah Memorial Hospitals, Bangalore – Karnataka
,
Dheeraj Karanth
Department of Gastroenterology, M.S. Ramaiah Memorial Hospitals, Bangalore – Karnataka
› Author Affiliations
Further Information

Publication History

Publication Date:
26 September 2019 (online)

  PDF Download Permissions and Reprints

ABSTRACT

Background and objectives: Rubber band ligation (BL) is the most widely used technique for treatment of symptomatic internal haemorrhoids (IH) that are refractory to conservative treatment. The aim of this study is to assess the efficacy of colonoscopic BL as therapy for symptomatic IH.

Methods: Patients seen at our center with symptomatic IH who underwent BL between January 2006 and December 2011 were included in this prospective study. The clinical and colonoscopic details were entered in uniform structured data forms.

Results: Two hundred and eighteen consecutive patients with symptomatic IH were enrolled in the study. The presentations were rectal bleeding in 150 (69%) and prolapse in remaining 68 (31%) patients. Twenty-four patients (11%) had chronic liver disease (child B-C). Same operator treated all the patients. The severity of the IH was classified by using Goligher grading system. The mean age of patients was 48.3 + 15 years with range of 22 - 85 years. The mean follow up was 3months (range 1 month - 36 months). In 209 patients (96%) there was at least 1 grade reduction in hemorrhoids as well the symptoms were controlled. Two patients required surgery and another 7 patients required repeat session of banding. After banding session 32 (15%) patients had perianal pain and 13 (6%) had mild bleeding.

Conclusions: Colonoscopic BL is a safe, and effective outpatient therapeutic procedure for symptomatic internal hemorrhoids. Furthermore, the BL is safe and effective in patients of coagulopathy associated with chronic liver disease. (J Dig Endosc 2013;4(1):6–9)

Key Words:

Haemorrhoids - Haemorhoid Band - Ligation - Colonoscopic banding
 

  • References

  • 1 Lorenzo-Rivero, S. Hemorrhoids: diagnosis and current management. Am Surg 2009;75: 635-42. PMID19725283.
  • 2 Pfenninger JL, Surrell J. Nonsurgical treatment options for internal hemorrhoids. Am Fam Physician 1995;52:821-34.
  • 3 Salvati EP. Nonoperative management of hemorrhoids: evolution of the office management of hemorrhoids. Dis Colon Rectum 1999;42:989-93.
  • 4 MacRae HM, Mcleod RS. Comparison of hemorrhoidal treatment modalities: a meta-analysis. Dis Colon Rectum 1995; 38:687-94.
  • 5 Schrock TR. Hemorrhoids: nonoperative and interventional management. In: Barkin J, and O′Phelan CA, editors. Advanced therapeutic endoscopy. New York: Raven Press; 1991.
  • 6 Su MY, Chiu CT, Wu CS, Ho YP, Lien JM, Tung SY, Chen PC. Endoscopic hemorrhoidal ligation of symptomatic internal hemorrhoids. Gastrointest Endosc 2003; 58:871.
  • 7 Trowers EA, Ganga U, Rizk R, Ojo E, Hodges D. Endoscopic hemorrhoidal ligation: preliminary clinical experience. Gastrointest Endosc 1998;48:49-52.
  • 8 Berkelhammer C, Moosvi SB. Retroflexed endoscopic band ligation of bleeding internal hemorrhoids. Gastrointest Endosc 2002;55:532-7.
  • 9 Johanson JF, Rimm A. Optimal nonsurgical treatment of hemorrhoids: a comparative analysis of infrared coagulation, rubber band ligation, and injection sclerotherapy. Am J Gastroenterol 1992; 87:1600.
  • 10 Peng BC, Jayne DG, Ho YH. Randomized trial of rubber band ligation vs. stapled hemorrhoidectomy for prolapsed piles. Dis Colon Rectum 2003; 46:291.
  • 11 Cataldo P, Ellis CN, Gregorcyk S, Hyman N, Buie WD, Church J, et al. Practice parameters for the management of hemorrhoids (revised). Dis Colon Rectum 2005; 48:189-94.
  • 12 Marshman D, Huber PJ Jr, Timmerman W, Simonton CT, Odom FC, Kaplan ER. Hemorrhoidal ligation. A review of efficacy. Dis Colon Rectum 1989;32:369.