Surgery may be a better option for severe hemorrhoids than having them tied off with a rubber band.

That's according to researchers writing in The Cochrane Library. They reviewed three studies comparing the two procedures. A total of 206 hemorrhoid patients participated. The results showed each procedure's pros and cons.

Procedures' Pluses, Minuses

Rubber band ligation was less painful, required less down time, and had fewer complications. This procedure involves tying off the hemorrhoid with a rubber band. The hemorrhoid tissue cut off by the rubber band dies.

Surgical removal was more effective in the long run, at least for severe hemorrhoids, write the researchers.

Patients seemed equally satisfied with and accepting of both treatments. That implies that patients preferred "complete long-term cure of symptoms" and were possibly less concerned about minor complications, write the researchers.

They included Venkatesh Shanmugam, a clinical research fellow in the surgery department of Scotland's Aberdeen Royal Infirmary.

Read WebMD's "What Are the Symptoms of Hemorrhoids?"

The Researchers' Verdict

Rubber band ligation can be adopted as the choice of treatment for moderate hemorrhoids with similar results but without the side effects of surgery, write Shanmugam and colleagues.

They would reserve surgery for more severe hemorrhoids or patients who get hemorrhoids again after rubber band ligation.

Read WebMD's "Botox Eases Hemorrhoid Surgery Pain"

Common Problem

Many people experience hemorrhoids at some point in their life.

Hemorrhoids are enlarged veins that develop in the anal canal. They can be uncomfortable but are rarely a major health threat.

However, other serious health problems — like colon and rectal cancer — have many of the same symptoms as hemorrhoids.

Check with your doctor if you notice:

— Rectal bleeding that is not associated with trying to pass stools

— Stools becoming more narrow than usual (may be no wider than a pencil)

— Inability to pass stools

— Diarrhea with abdominal bloating

— Black or tarry stools

— Any unusual material seeping from the anus

— Fever with bloody stools or what you think are hemorrhoids

— A lump or bulge at the anal opening that is not tender and does not go away

If you have hemorrhoids, call your doctor if you have:

— Moderate rectal pain lasting longer than one week after home treatment

— Severe pain or swelling

— Tissue from inside the body bulging from the anus that doesn't return to normal after 3 to 7 days of home treatment

— A lump inside the anus that becomes bigger or more painful

Read WebMD's "Learn the Basics about the Digestive System"

By Miranda Hitti, reviewed by Michael W. Smith, MD

SOURCES: Shanmugam, V. The Cochrane Library, 2005, issue 2. WebMD Medical Reference from Healthwise: "What Are Hemorrhoids?" WebMD Medical Reference from Healthwise: "Hemorrhoids: When to Call a Doctor." Health Behavior News Service.