Rubber band ligation
Patients with grades II or III internal hemorrhoids are candidates for rubber band ligation
Rubber band ligation is the most commonly used technique for the treatment of symptomatic bleeding internal hemorrhoids. This technique is effective, inexpensive, easy to perform, and only rarely causes serious complications.
Sclerotherapy
Injectable sclerosant solutions can also be used to treat symptomatic internal hemorrhoids. The most common solution used is phenol (5 percent) in vegetable oil, although other sclerosants such as sodium morrhuate, quinine, urea hydrochloride, sodium tetradecyl sulfate (Sotradecol), and hypertonic saline have all been used. The sclerosant causes an intense inflammatory reaction, destroying redundant submucosal tissue associated with hemorrhoidal prolapse.
This approach appears to be especially beneficial for treating patients with grade I and II bleeding internal hemorrhoids, and those patients treated with anticoagulants. Hemorrhoidal sclerotherapy may be less effective than rubber band ligation
Infrared coagulation
Infrared coagulation involves the direct application of infrared light waves to the hemorrhoidal tissues. Patients with grades I or II bleeding internal hemorrhoids are candidates for this procedure.