Rubber Band Ligation versus Injection Sclerotherapy for the Management of Grade I and Grade II Haemorrhoids: A Prospective Interventional Study
Introduction: Several approaches are available for treating haemorrhoids, ranging from conservative in-office procedures to more invasive surgeries. Rubber Band Ligation (RBL) and Injection Sclerotherapy (SCL) are two widely used, minimally invasive techniques that can be performed in an office sett...
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JCDR Research and Publications Private Limited
2025-05-01
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| author | Kanika Sharma Ramachandran Ponniah Iyyappan Ponmani Agasthiya Manimaran Sanniyasi Saravanan |
| author_facet | Kanika Sharma Ramachandran Ponniah Iyyappan Ponmani Agasthiya Manimaran Sanniyasi Saravanan |
| author_sort | Kanika Sharma |
| collection | DOAJ |
| description | Introduction: Several approaches are available for treating haemorrhoids, ranging from conservative in-office procedures to more invasive surgeries. Rubber Band Ligation (RBL) and Injection Sclerotherapy (SCL) are two widely used, minimally invasive techniques that can be performed in an office setting. While both methods relieve symptoms and enhance patients’ quality of life, they vary in mechanisms, techniques, and outcomes. Despite their popularity, there is limited comparative research on their efficacy, safety, and patient satisfaction.
Aim: To compare RBL and SCL regarding post-procedural pain, bleeding, relief of symptoms, and recurrence.
Materials and Methods: A prospective interventional study was conducted at Sri Ramachandra Institute of Higher Education and Research, Chennai, from July 2019 to July 2021. A total of 60 patients over the age of 18 years, with grade I or II haemorrhoids, undergoing RBL or injection SCL were included. Patients were recruited by convenience sampling and allocated alternately, i.e., RBL (n=30) or SCL (n=30), and systematically compared in terms of post procedural pain, bleeding, relief of symptoms, and recurrence. Data was analysed using IBM SPSS version 23.0 statistics software. The t-tests and Chi-square tests were applied and p-value of <0.05 was considered significant.
Results: The mean pain score immediately post-procedure (30 minutes) was 2.6 and 1.7 in the RBL and SCL groups, respectively, p=0.024. The same trend was reported on day zero and mean pain score was significantly lower in the SCL group (0.37) as compared to the RBL group (0.93), p=0.008. In the first week, 53.3% of the RBL group presented with bleeding as compared to 20% of the SCL group, p=0.007. Patients in the RBL group reported better relief of symptoms (i.e., pain, bleeding, pruritus, sensation of mass per rectum) than patients in the SCL group, 93.3%, and 83.3%, respectively, though this data was not statistically significant. The RBL group had one recurrence (3.3%) and the SCL group had three recurrences (10%).
Conclusion: The SCL group outperformed the RBL group regarding pain and bleeding in the first week post-procedure. However, clinically the pain experience was similar for both groups. While data beyond the first week was not statistically significant, SCL remains a safe and effective treatment for early haemorrhoids. |
| format | Article |
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| institution | DOAJ |
| issn | 2249-782X 0973-709X |
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| publishDate | 2025-05-01 |
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| spelling | doaj-art-5dd784a3d2f24ade9247a609941d9d442025-08-20T02:56:03ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-05-01195PC01PC0510.7860/JCDR/2025/75694.20942Rubber Band Ligation versus Injection Sclerotherapy for the Management of Grade I and Grade II Haemorrhoids: A Prospective Interventional StudyKanika Sharma0Ramachandran Ponniah Iyyappan1Ponmani Agasthiya Manimaran2Sanniyasi Saravanan3Postgraduate, Department of General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.Associate Professor, Department of General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.Postgraduate, Department of General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.Professor and Chief, Department of General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.Introduction: Several approaches are available for treating haemorrhoids, ranging from conservative in-office procedures to more invasive surgeries. Rubber Band Ligation (RBL) and Injection Sclerotherapy (SCL) are two widely used, minimally invasive techniques that can be performed in an office setting. While both methods relieve symptoms and enhance patients’ quality of life, they vary in mechanisms, techniques, and outcomes. Despite their popularity, there is limited comparative research on their efficacy, safety, and patient satisfaction. Aim: To compare RBL and SCL regarding post-procedural pain, bleeding, relief of symptoms, and recurrence. Materials and Methods: A prospective interventional study was conducted at Sri Ramachandra Institute of Higher Education and Research, Chennai, from July 2019 to July 2021. A total of 60 patients over the age of 18 years, with grade I or II haemorrhoids, undergoing RBL or injection SCL were included. Patients were recruited by convenience sampling and allocated alternately, i.e., RBL (n=30) or SCL (n=30), and systematically compared in terms of post procedural pain, bleeding, relief of symptoms, and recurrence. Data was analysed using IBM SPSS version 23.0 statistics software. The t-tests and Chi-square tests were applied and p-value of <0.05 was considered significant. Results: The mean pain score immediately post-procedure (30 minutes) was 2.6 and 1.7 in the RBL and SCL groups, respectively, p=0.024. The same trend was reported on day zero and mean pain score was significantly lower in the SCL group (0.37) as compared to the RBL group (0.93), p=0.008. In the first week, 53.3% of the RBL group presented with bleeding as compared to 20% of the SCL group, p=0.007. Patients in the RBL group reported better relief of symptoms (i.e., pain, bleeding, pruritus, sensation of mass per rectum) than patients in the SCL group, 93.3%, and 83.3%, respectively, though this data was not statistically significant. The RBL group had one recurrence (3.3%) and the SCL group had three recurrences (10%). Conclusion: The SCL group outperformed the RBL group regarding pain and bleeding in the first week post-procedure. However, clinically the pain experience was similar for both groups. While data beyond the first week was not statistically significant, SCL remains a safe and effective treatment for early haemorrhoids.https://jcdr.net/articles/PDF/20942/75694_CE[Ra1]__F(IS)_QC_PF1_(KrA_OM)_PFA(IS)_PB(KrA_IS)_PN(IS).pdfhaemorrhoidectomyoutpatientproctology |
| spellingShingle | Kanika Sharma Ramachandran Ponniah Iyyappan Ponmani Agasthiya Manimaran Sanniyasi Saravanan Rubber Band Ligation versus Injection Sclerotherapy for the Management of Grade I and Grade II Haemorrhoids: A Prospective Interventional Study Journal of Clinical and Diagnostic Research haemorrhoidectomy outpatient proctology |
| title | Rubber Band Ligation versus Injection Sclerotherapy for the Management of Grade I and Grade II Haemorrhoids: A Prospective Interventional Study |
| title_full | Rubber Band Ligation versus Injection Sclerotherapy for the Management of Grade I and Grade II Haemorrhoids: A Prospective Interventional Study |
| title_fullStr | Rubber Band Ligation versus Injection Sclerotherapy for the Management of Grade I and Grade II Haemorrhoids: A Prospective Interventional Study |
| title_full_unstemmed | Rubber Band Ligation versus Injection Sclerotherapy for the Management of Grade I and Grade II Haemorrhoids: A Prospective Interventional Study |
| title_short | Rubber Band Ligation versus Injection Sclerotherapy for the Management of Grade I and Grade II Haemorrhoids: A Prospective Interventional Study |
| title_sort | rubber band ligation versus injection sclerotherapy for the management of grade i and grade ii haemorrhoids a prospective interventional study |
| topic | haemorrhoidectomy outpatient proctology |
| url | https://jcdr.net/articles/PDF/20942/75694_CE[Ra1]__F(IS)_QC_PF1_(KrA_OM)_PFA(IS)_PB(KrA_IS)_PN(IS).pdf |
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