Office treatments for hemorrhoids

These procedures are done by a clinician. ahem does not perform them. The home-care list is a different page, what actually helps with hemorrhoids.

NIDDK last reviewed its treatment page in October 2016. Opened again on October 25, 2026, it says doctors use rubber band ligation for bleeding or prolapsing internal hemorrhoids. A doctor places a special rubber band around the base. The band cuts off the blood supply. The banded part shrivels and falls off, most often within a week. Scar tissue forms in what remains, often shrinking the hemorrhoid. NIDDK says only a doctor should do this, and that you should never try it yourself.

Mayo Clinic dates its treatment page August 23, 2025. On the copy checked October 25, 2026, it says a clinician places one or two tiny rubber bands around the base of an internal hemorrhoid to cut off blood flow. The hemorrhoid withers and falls off within a week. Mayo Clinic says banding can be uncomfortable and can cause bleeding. That bleeding might begin 2 to 4 days after the procedure and is rarely severe. It also says more serious complications can occur.

NIDDK describes sclerotherapy as an injection into an internal hemorrhoid. The solution causes scar tissue, the scar tissue cuts off the blood supply, and the hemorrhoid often shrinks. Mayo Clinic describes the same idea, a chemical solution injected to shrink the tissue. It says the injection causes little or no pain, and that it might be less effective than rubber band ligation. NIDDK's page does not make that comparison.

Heat is not one device on these pages. NIDDK describes infrared photocoagulation, a tool that directs infrared light so heat forms scar tissue and cuts off blood supply, and electrocoagulation, a tool that sends an electric current for the same kind of scar. Mayo Clinic groups coagulation techniques that use laser, infrared light, or heat, and says they are for small bleeding internal hemorrhoids, with few side effects and usually little discomfort. A page that collapsed those names into one gadget would be inventing a product.

Banding, on both pages, is for an internal hemorrhoid. A clot in an external hemorrhoid is the case Mayo Clinic treats separately. On the treatment page checked October 25, 2026, it says a clinician can remove that hemorrhoid, the removal can relieve pain right away, and it is done with a local anesthetic. Thrombectomy works best within 72 hours of the clot. NIDDK's treatment page does not give the 72-hour figure.

How that clot fits the usual few days or week of symptoms is on how long hemorrhoid symptoms usually last.

NIDDK says a hemorrhoidectomy removes large external hemorrhoids and prolapsing internal hemorrhoids that do not respond to other treatments. A surgeon, most often, does it, and the doctor gives anesthesia. Hemorrhoid stapling, also most often done by a surgeon under anesthesia, uses a stapling tool to remove internal hemorrhoid tissue and pull a prolapsing internal hemorrhoid back into the anus.

Mayo Clinic says only a small percentage of people with hemorrhoids need surgery to remove them, and that a clinician might recommend it if other procedures have not worked or the hemorrhoids are large. It says hemorrhoidectomy can be done with local anesthetic plus a sedative, or with spinal or general anesthesia. Most people have some pain afterward. Medicines can ease it, and a warm bath might help. Stapling, which Mayo Clinic also calls stapled hemorrhoidopexy, blocks blood flow to the tissue and is typically used only for internal hemorrhoids.

Mayo Clinic says minimally invasive office treatments usually do not require numbing medicine, and that they are considered for bleeding that does not stop or for painful hemorrhoids. That sentence sits above banding, sclerotherapy, and coagulation on its page. It is not a promise that banding is painless. The banding paragraph above is the one that mentions discomfort and bleeding.

It does not assign you a procedure. NIDDK and Mayo Clinic describe who the treatments are for in the sentences above, and they leave the choice with the clinician who has done an exam. What that exam includes is on what a hemorrhoid exam checks.