Several procedures can be done in a doctor’s office, and each has advantages and disadvantages.
Rubber-Band Ligation (Banding)
Your doctor will take a tiny rubber band (only a few millimeters wide) and put it over the base of an internal hemorrhoid to cut off the flow of blood. The hemorrhoid usually shrinks and falls off (along with the band) in about a week.
If you have several hemorrhoids, you may need to have this done every few weeks. This treatment can be painful and cause bleeding. More rarely, it also may cause blood clots or infections.
Hemorrhoids treated this way are less likely to come back than with other treatments.
Your doctor will give you a shot that puts chemicals into the hemorrhoid tissue. These chemicals also cut off blood flow to the hemorrhoids and shrink them. You may need to have this done every few weeks until they go away completely.
You may feel mild pain or pressure after, but infections are rare. With this treatment, the hemorrhoids often come back in a few years.
With this treatment, your doctor focuses an infrared light on a hemorrhoid, and the heat causes scar tissue to form and blood flow to the hemorrhoid to be cut off.
Generally, coagulation treatments have few side effects and cause very little pain. However, hemorrhoids are more likely to come back with these treatments than with banding.
This is similar to infrared coagulation, except instead of an infrared light, your doctor uses heat from an electric current to create scar tissue and cut off the hemorrhoid’s blood supply.
Hemorrhoidal Artery Ligation and Recto Anal Repair (HAL-RAR)
Hemorrhoidal Artery Ligation and Recto Anal Repair (HAL-RAR) is a new procedure in which a miniature Doppler sensor is inserted in the anus to detect the arteries supplying blood to hemorrhoids. The surgeon can pinpoint the arteries supplying the hemorrhoids and can tie them off to cut the blood supply. The hemorrhoids are reduced almost immediately and within weeks, are no longer noticeable. The procedure is effective and virtually painless, but it is not simple.