Procedures

Hemorrhoid Banding

As noted on our ‘Conditions‘ page, hemorrhoids are swollen veins that occur in the rectum or around the anus. At their worst, hemorrhoids can be extremely itchy and painful, and even lead to bleeding during bowel movements. While hemorrhoids are frequently uncomfortable, they are generally non-life-threatening and can be treated at home with diet change, cold compresses, or over-the-counter creams that contain hydrocortisone. However, hemorrhoids occasionally do not respond to at-home methods and need to be treated surgically using a technique called hemorrhoid banding.

Hemorrhoid banding, also known as rubber band ligation, is a minimally invasive procedure that uses a small rubber band to stop the flow of blood to a hemorrhoid in order to decrease the swelling and, in turn, ease discomfort to the patient.

This procedure is usually performed in an outpatient setting, but can also be done in a physician’s usual office. Before the procedure, patients are either given general anesthesia or topical anesthetic is applied directly to the rectum. After the patient is anesthetized, the physician will insert a tool called an anoscope into the rectum and locate the hemorrhoid. The anoscope is a small tube with a light on the end, which then has a small instrument called a ligator passed through it, up to the site of the hemorrhoid. The ligator is then used to place one to two rubber bands at the base of the hemorrhoid to restrict blood flow to the vein. This process will be repeated for any additional hemorrhoids. During the process, if any blood clots are discovered, the physician will remove them as well. Hemorrhoid banding is an extremely low-risk procedure. It generally only takes a few minutes from start to finish; this timeframe can be extended if the patient has multiple hemorrhoids or blood clots.

Preparation for this procedure will vary from patient to patient, but typically food and drink will be restricted before the procedure, especially if the patient is being put under general anesthesia. Patients should always alert their physician to any over-the-counter or prescription medications being taken before the procedure and notify their doctor if they have any allergies. Although hemorrhoid banding is an outpatient procedure, patients should be accompanied by a companion who can drive them to and from the appointment, and help them avoid straining after the procedure. While the risks associated with hemorrhoid banding are extremely low, lifting heavy objects or too much activity can pose unnecessary complications.

After the procedure, the hemorrhoids will typically dry up and fall off on their own. This is expected to happen within 1-2 weeks of the banding. This usually occurs during bowel movements, so patients won’t always notice that the dried hemorrhoids have fallen off. In the days following the hemorrhoid banding procedure, there are several mildly uncomfortable symptoms that patients can expect to experience:

• Flatulence, or a buildup of gas in the stomach
• Abdominal pain or swelling
• Constipation
• Bleeding from the rectum (This is normal, but should not continue for more than three days)

Physicians will sometimes recommend an over-the-counter stool softener or laxative to prevent constipation or bleeding.

Hemorrhoid banding is a very safe procedure, but patients should always be conscious of the risks and keep an eye out for the following symptoms after their procedure:

• Infection
• Excessive bleeding during bowel movements
• Difficulty urinating
• Recurring hemorrhoids

If any of these complications occur, patients are encouraged to reach out to their physician’s office immediately.