What we perform in the office
Most hemorrhoids can be treated without surgery. Hamilton Hemorrhoids performs three main procedures in our office, each suited to different grades and types of hemorrhoids. Before we recommend any procedure, we examine you and grade your hemorrhoids. This examination tells us exactly what we are working with, and it is how we match the right treatment to your situation.
The procedures we perform are rubber band ligation, infrared coagulation, and sclerotherapy. Each one works differently, takes a different amount of time, and suits different hemorrhoid grades. Understanding how they differ helps you know what to expect when you arrive.
Rubber band ligation explained
Rubber band ligation is the most common office procedure we perform. It works by placing a small rubber band around the base of an internal hemorrhoid, cutting off its blood supply. The hemorrhoid shrinks and eventually falls away. The procedure takes only a few minutes and causes minimal discomfort during the placement.
How many sessions does it take?
A course of rubber band ligation commonly runs to two or three visits. Each session treats one hemorrhoid column, so the number of visits depends on how many hemorrhoids need treatment. We space sessions apart to allow healing between them.
Infrared coagulation for hemorrhoids
Infrared coagulation uses heat to seal the blood vessels feeding a hemorrhoid. A probe delivers infrared light to the base of the hemorrhoid, causing the tissue to coagulate and the hemorrhoid to shrink. This procedure works well for grade 1 and grade 2 hemorrhoids and some grade 3 cases.
Infrared coagulation is quick and leaves no open wound. Like banding, it typically requires two or three sessions to treat all the hemorrhoids. The procedure causes minimal pain during treatment, and most patients return to normal activity the same day.
- Works on internal hemorrhoids only
- No incisions or sutures needed
- Minimal bleeding risk
- Quick recovery between sessions
Sclerotherapy: injecting to shrink
Sclerotherapy involves injecting a chemical into the hemorrhoid tissue. The injection causes the hemorrhoid to shrink and scar down. It works best on grade 1 and grade 2 internal hemorrhoids. The injection itself takes seconds, and the whole procedure is over in minutes.
Sclerotherapy requires the fewest office visits of the three procedures. Many patients need only one or two sessions. There is no cutting, no banding, and no heat involved. The injection site may feel tender for a day or two, but serious side effects are rare.
Who is a good candidate?
Sclerotherapy works well for patients who want a quick procedure with minimal sensation during treatment. It is less effective on grade 4 hemorrhoids or those that have prolapsed outside the body. We determine suitability during your examination.
Why examination comes before treatment
We do not choose a procedure based on what you describe over the phone or what you read online. We examine you first. An anoscopy lets us see exactly what grade your hemorrhoids are, whether they are internal or external, and whether any other conditions are present. This examination is how we know which procedure will work best for you.
Some patients have mixed hemorrhoids, internal and external at the same time. Others have grade 3 or grade 4 hemorrhoids that need a different approach. A few have other conditions that need attention first. The examination catches all of this.
When surgery becomes the right choice
Not every hemorrhoid can be treated in the office. Grade 4 hemorrhoids, severely prolapsed hemorrhoids, and some grade 3 cases need surgical treatment. We also refer patients for surgery if office procedures have not worked or if a hemorrhoid comes back repeatedly.
Hamilton Hemorrhoids performs or refers for hemorrhoidectomy, stapled hemorrhoidopexy, and dearterialisation. During your examination, we tell you honestly whether your hemorrhoids are suitable for office treatment or whether surgery is the better option.
The decision is not about what is easiest for us. It is about what will work best for you. Some patients are relieved to learn that office treatment is possible. Others find that knowing surgery is the right path lets them move forward with confidence.
Understanding cost and session count
The cost of treatment depends on how many sessions your course needs. Since a session treats one hemorrhoid column, a typical course runs two to three visits. We provide a written cost estimate before you book any procedure, so you know what to expect.
how many banding sessions follows from anatomy rather than from a claim. You cannot treat three hemorrhoid columns in one visit, so the number of visits is predictable. We discuss this during your examination and answer any questions about what treatment costs.
Insurance coverage varies by plan and by procedure. We check your coverage before your appointment and discuss any out-of-pocket costs with you. You are never surprised by a bill.
Getting started in Hamilton
The first step is your first visit to Hamilton Hemorrhoids. We examine you, grade your hemorrhoids, and explain which procedures are suitable. You leave with a clear picture of what treatment looks like and what it costs.
You do not need a referral to book an appointment. Call us or use our online booking system. If you have questions before your visit, read our hemorrhoid questions or hemorrhoid treatment directly. We answer questions about what to expect and how to prepare.