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735 (95% CI 0.675 - 0.795). CONCLUSION There is a significant difference of scores between patients who were offered surgery and patients with successful rubber band ligation. Our study suggest that the Sodergren score has an acceptable discrimination in predicting the need for surgery in internal haemorrhoidal disease. We propose that patients with a Sodergren score of 6 or more be considered for upfront surgery. It has potential to be used to standardize outcomes of future haemorrhoidal trials. This article is protecte