Getting on the bandwagon

Is banding of haemorrhoids as effective as surgical haemorrhoidectomy?

If dietary changes are not effective at reducing the symptoms of haemorrhoids, patients may seek more definitive treatment. Ligation of the haemorrhoids using a rubber band is one option with a high success rate that can be used outside hospital.

A Cochrane review has looked for randomised trials that compared excisional haemorrhoidectomy with rubber band ligation. Although 586 abstracts were assessed, only three trials met the inclusion criteria, and the most recent study was published in 1983.

There was a total of 206 patients in the trials. They had mean ages of 40–53 years and had experienced symptoms from their haemorrhoids for 54–112 months.

At the end of the studies, the overall cure rate was higher with surgical excision. This was explained by an advantage for surgery in patients who had prolapsed, but reducible, haemorrhoids. There