ABSTRACT

Objective: To assess the outcome of rubber band ligation in treatment of grade III and grade IV haemorrhoids.

Study Design: Prospective interventional study.

Place and Duration: Department of Surgery, Balfour Hospital. 1^st of January 2014 to the 1^st of January 2021.

Methodology: All patients with Grade III and IV degree haemorrhoids were offered to have multiple sessions of haemorrhoid banding as an alternative to surgical intervention. All patients were followed up after 3 months, 6 months and 12 months in the colorectal clinic, and then telephonic consultation at 24 months to assess patient satisfaction, impact on quality of life, recurrence of symptoms (bleeding, itching, discomfort, pain) and whether they would recommend this procedure to others based on their experiences.

Results: Out of a total of 210 patients included in this study, 58.6% had grade III haemorrhoids and 41.4% had grade IV on clinical examination. Two banding sessions were required in 69.1% of the cases and three sessions needed in the remaining 38.09% patients. Post banding sessions; Haemorrhoidectomy was required in 2.85% of patients with grade III and 4.28% of patients with grade IV haemorrhoids. In follow up, 4.28% patients reported mild discomfort, 0.47% had to be taken back to theatre for removal of bands. Of the cohort 7.14% reported no improvement to symptoms.   

Conclusion: Rubber band ligation in Grade III and IV haemorrhoids was found to be an effective treatment modality in our patients. We recommend using multiple sessions of banding of haemorrhoids to treat grade three and especially grade four haemorrhoids in selected patients as an alternative, since our study concludes that it yields favourable results.  

Keywords: Haemorrhoids, 3rd degree, 4th degree, Management, Band ligation, Multiple sessions, Outcome, Haemorrhoidectomy

How to Cite This:

Gandiya T, Hina S, Rafi A U, Alubaidi K. Changing the approach to Grade III and Grade IV Haemorrhoids management: A single centre experience in a Remote and Rural Setting. Isra Med J. 2021; 13(4): 246-249.

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