Internal hemorrhoid disease is the most common clinical proctologic disorder. Surgical treatment is the obvious therapeutic strategy for this disease, but due to the significant complications, non-invasive approaches are preferred rather than surgical one. The current study aims to assess the one-year follow-up outcomes of medical therapy and rubber band ligation (RBL) for the management of internal hemorrhoid.

The current non-randomized clinical trial has been conducted on 57 patients with rectal bleeding due to grade II-III internal hemorrhoid disease assigned whether in medical treatment with antihemorrhoid cream (n=30) or RBL (n=27). Medical treatment was applied thrice daily until complete bleeding control. RBL was performed for the patients and repeated through monthly visits, if needed. The outcomes, recurrence and complications were compared between the group in a twelve-month follow-up.

The mean period of antihemorrhoid cream administration to control bleeding was 5.05±2.17 days. The bleeding was well-controlled within 6-8 days in 83.2% of the patients. . Bleeding reocurred for 3.53±1.94 times/year in medical treatment. There was an inverse correlation between age and recurrence in medically-treated patients (r=-0.78, P-value<0.001). RLB was needed once, twice and thrice in 25%, 29.6% and 44.4% of the patients, respectively. Three RBL patients (11.11%) experienced complications, including pain(two ones: 7.40%) and insignificant bleeding (1 patient: 3.70%).

According to the current study, considering the negligible complications and appreciable success rate of RBL for the eradication of grade II/ III hemorrhoid disease, this procedure can be recommended as the choice approach of low-to-moderate grade hemorrhoid disease, in drug resistant conditions, in particular