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General Surgery · Anorectal: second degree haemorrhoids
Sample itemA 40-year-old has painless bright red bleeding after defaecation, and piles that prolapse on straining and reduce spontaneously. What is a suitable office treatment?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Rubber band ligation
Second degree haemorrhoids prolapse and reduce spontaneously and are managed by dietary fibre first, then rubber band ligation if symptoms persist. Surgery is used for large grade III and IV piles or failure of banding. Band ligation is applied above the dentate line where there is no somatic pain sensation.
Option by option
A. Haemorrhoidectomy as the first step
Haemorrhoidectomy is more morbid and kept for advanced piles.
B. Lateral internal sphincterotomy
Sphincterotomy treats fissure.
C. Rubber band ligation (correct)
Correct. Banding is effective for grade I to II and selected III piles.
D. Incision and drainage
Drainage is for abscess.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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