Infrared photocoagulation (also called coagulation therapy) is a medical procedure used to treat small- and medium-sized hemorrhoids. During the procedure, the doctor uses a device that creates an intense beam of infrared light. Heat created by the infrared light causes scar tissue, which cuts off the blood supply to the hemorrhoid. The hemorrhoid dies, and a scar forms on the wall of the anal canal. The scar tissue holds nearby veins in place so they don't bulge into the anal canal.

Only one hemorrhoid can be treated at a time. Other hemorrhoids may be treated at 10- to 14-day intervals.

This medical procedure may be performed with other devices, such as a laser or electrical current, that also cut off a hemorrhoid's blood supply.

Infrared photocoagulation is done in a doctor's office. You may feel heat and some pain during the procedure. Afterward, you may have a sensation of fullness in the lower abdomen, or you may feel as if you need to have a bowel movement.

What To Expect After Treatment

Bleeding from the anus occurs 7 to 10 days after the procedure, when the hemorrhoid falls off. Bleeding is usually slight and stops by itself.

• You may use mild pain relievers and sit in a shallow tub of warm water (sitz bath) for 15 minutes at a time to relieve discomfort.
• To reduce the risk of bleeding, avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs) for 4 to 5 days both before and after infrared coagulation.
• Health professionals recommend that you take stool softeners containing fiber to ensure smooth bowel movements. If you strain during bowel movements, hemorrhoids can recur.

Why It Is Done

Doctors recommend coagulation therapy in cases where small internal hemorrhoids continue to cause symptoms after home treatment.

How Well It Works

The choice of treatment depends on the size of the hemorrhoid. The success of the treatment depends on a variety of factors, including which treatment is used and whether contributing factors (such as constipation) can be changed.

• Small internal hemorrhoids are often successfully treated with coagulation therapy. Large hemorrhoids are more likely to be treated with rubber band ligation.
• One large study comparing infrared photocoagulation therapy, rubber band ligation, and injection sclerotherapy showed that infrared photocoagulation caused fewer and less serious complications.¹

Risks

Risks of coagulation therapy include:

• Considerable pain during the procedure.
• Bleeding from the anus.
• Infection in the anal area.
• Temporary inability to urinate.

What To Think About

The success of coagulation therapy depends largely on the doctor's expertise and your ability to make changes in daily bowel habits that will make passing stools easier.

Coagulation therapy is expensive, but it is less expensive than surgery that requires a hospital stay and time away from work.

Not all doctors have the experience or the necessary equipment to do coagulation therapy. This may help you decide which procedure to choose. Ask your doctor which procedure he or she has done the most, how many times he or she has done the procedure, and how satisfied people have been with the outcomes.

Lasers have not been proven to be more effective than other forms of treatment. Procedures using lasers are much more expensive, take longer, and may damage surrounding tissue and cause more scarring.

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Citations

1. Johanson JF, Rimm A (1992). Optimal nonsurgical treatment of hemorrhoids: A comparative analysis of infrared coagulation, rubber band ligation, and injection sclerotherapy. American Journal of Gastroenterology, 87(11): 1601–1606.