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April 29, 1968

Nonoperative Ligation Treatment of Internal Hemorrhoids

Author Affiliations

From the Department of Surgery, the Permanente Clinic, Portland, Ore.

JAMA. 1968;204(5):375-376. doi:10.1001/jama.1968.03140180025006

A hemorrhoidectomy is extremely unpleasant for the patient. He has a great deal of pain afterward, and he can vividly recall his first postoperative bowel movements for a very long time! After several well-remembered days in the hospital, he is still usually unable to return to work for one to three weeks. In addition to the pain and suffering, the operation can cost a lot of money. If the surgeon's and the anesthesiologist's fees, the operating room and hospital charges, and the patient's lost earnings are totaled, the expense is often considerable.

Hemorrhoids are essentially benign. They rarely, if ever, threaten life. After all, hemorrhoids are only varicosities occurring in veins normally present in the rectum. Asymptomatic hemorrhoids probably need not be treated at all. Hemorrhoids, however, can be most unpleasant and disagreeable. They can bleed; they can protrude. Often they are quite uncomfortable. Sometimes they hurt. As a rule,