Comparing Treatments for Bleeding Internal Hemorrhoids

Internal hemorrhoids as a cause of rectal bleeding are often discovered during colonoscopy or sigmoidoscopy. Therapy usually involves a thermal technique such as bipolar electrocoagulation (BPEC) or infrared photocoagulation. Although some gastroenterologists use rubber band ligation (RBL), many hesitate to do so because of the risk for severe pain, bleeding, and — rarely — serious infection associated with this method. Overall, the literature suggests that RBL is more effective than thermal therapies for grade II and III internal hemorrhoids, but no previous randomized trial has directly compared RBL with BPEC.

To provide such a comparison, investigators randomized 45 adults with bleeding grade II or III internal hemorrhoids (for which inte…