Infrared Coagulation

Infrared coagulation (IRC) uses focused infrared energy to create controlled scarring in hemorrhoidal tissue — a quick, generally low-pain office procedure comparable in effectiveness to rubber band ligation in several studies, though findings vary.

Key takeaways

IRC applies infrared energy through a probe to create localized coagulation and scarring, reducing blood supply and fixing tissue in place.
It’s generally reported as low-pain or painless by patients, and is done quickly in the office.
Studies comparing IRC to rubber band ligation show mixed results — some found comparable long-term success, others found RBL somewhat more effective.

How it works

A specially designed device delivers infrared energy through a proctoscope directly to the base of the hemorrhoid, causing localized coagulation (a controlled burn) that leads to submucosal fibrosis and mucosal fixation — shrinking the tissue and reducing bleeding and prolapse over time as scarring develops.

What the procedure feels like

IRC is generally reported as low-pain or entirely painless in published studies — a genuine advantage over some alternatives, since the energy is applied briefly and precisely without significant tissue trauma to sensitive areas.

How it compares to rubber band ligation

Research comparing IRC and RBL has produced mixed findings: some studies found the two approaches roughly equivalent in long-term symptom control, with reported ranges of 59–97% success for RBL compared to 81–98% for IRC across different studies, while a couple of studies found RBL significantly more effective. This range itself is informative — it suggests real variability between practices, techniques, and patient populations rather than a single settled answer favoring one method decisively over the other.

What it’s typically used for

IRC is generally used for smaller, earlier-grade internal hemorrhoids, similar to the population often treated with sclerotherapy or single-session banding.

Recovery

Recovery is typically quick and similar to other office procedures in this section — most people return to normal activities the same day, with minimal downtime.

When IRC might be preferred over banding

Given its generally low-pain profile, IRC may be a reasonable option to discuss if you’re specifically concerned about procedure-related pain, or if your doctor has experience and equipment for this approach as their standard first-line option.

When to see a doctor after the procedure

Bleeding or pain beyond what was described as expected
Any signs of infection
Symptoms not improving as expected within the timeframe your doctor described

Want the full comparison across all office procedures? See Comparing office procedures: success rates, pain, recurrence.

This page is for general education, based on published comparative studies with some variability in findings.