One hundred patients with second- or third-degree haemorrhoids were randomly allocated to haemorrhoidectomy (50) or rubber band ligation (50). Forty-two in each group presented with rectal bleeding; haemorrhoidectomy relieved 36 and rubber band ligation relieved 31 of this symptom. All patients had prolapsing haemorrhoids at presentation. One year after treatment 45 haemorrhoidectomy and 43 rubber band ligation patients were assessed. Haemorrhoidectomy relieved 44 of 45 patients and rubber band ligation relieved 34 of 43 (P < 0·05). Haemorrhoidectomy caused pain in all cases, lasting for more than 48 h in 35. Rubber band ligation was painless in 5 and produced pain for more than 48 h in 15. Mean time off work was 32 days for haemorrhoidectomy and 3 days for rubber band ligation (P < 0·001).
Rubber band ligation as an outpatient procedure is an effective treatment for second- and third-degree haemorrhoids and should be considered before recourse to surgery.