Rubber band ligation is a popular procedure for the treatment of hemorrhoids, as it involves a much lower risk of pain than surgical treatments of hemorrhoids, as well as a shorter recovery period. It is a very effective procedure, recurrence rate that is only 5% at 2 years.
A rubber band ligation is usually perfored if the hemorrhoid is not deemed too severe by the doctor.
-Rubber band ligation works for about 8 out of 10 people. People who have this treatment are less likely to need another treatment compared to people who have coagulation treatments. About 1 out of 10 people may need surgery.
-Rubber band ligation is generally safe procedure. There are a few risks that may occur such as infection, bleeding, fever, urinating problems, all of which will be attempted to be minimized by your doctor.
Rubber band ligation is usually performed as an outpatient procedure; this means that you won’t need to stay in a hospital. Before the procedure, you’ll be given anesthesia or have a topical anesthetic applied to your rectum. If your hemorrhoids are very painful, or you need to have a lot of them banded, you may need general anesthesia. Your doctor will then insert an anoscope into your rectum until it reaches the hemorrhoid. An anoscope is a small tube with a light at the end of it. They’ll then insert a small tool called a ligator through the anoscope. Your doctor will use the ligator to place one or two rubber bands at the base of the hemorrhoid to constrict blood flow. They’ll repeat this process for any other hemorrhoids. If your doctor finds any blood clots, these will be remove them during the banding process. In general, hemorrhoid banding only takes a few minutes, but it could take longer if you have multiple hemorrhoids.
Before the procedure, make sure you discuss with your doctor about all medications you take. You should also inform them about any herbal supplements you take. If you’re having anesthesia for this procedure, you may also need to avoid eating or drinking for several hours before the procedure.
After the procedure, you may feel pain and have a sensation of fullness in the lower abdomen. Or you may feel as if you need to have a bowel movement. Depending on different people, you maybe able to return to regular activities (but avoid heavy lifting) almost immediately. Others may need 2 to 3 days of bed rest.
Pain is likely for 24 to 48 hours after rubber band ligation. You may use pain killers such as acetaminophen and sit in a shallow tub of warm water (sitz bath) for 15 minutes at a time to relieve discomfort. To reduce the risk of bleeding, patients should avoid taking aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) for 4 to 5 days both before and after rubber band ligation. While this is generally a straightforward procedure, it is a good idea to have someone take you home and stay with you for a day or two following the procedure to help you around the house. This can help you avoid straining, which could lead to complications.
Bleeding may occur 7 to 10 days after surgery, when the hemorrhoid falls off. Bleeding is usually slight and stops by itself. Doctors recommend that you take stool softeners containing fiber and drink more fluids to ensure smooth bowel movements. Straining during bowel movements can cause hemorrhoids to come back.
Possible complications that may occur from a rubber band ligation include:
-Bleeding from the anus
-Infection at the anal area
-Inability to pass urine
How does rubber band ligation compare to other treatment methods used to treat hemorrhoids?
Depending on the grading of hemorrhoids, rubberband ligation is usually the preferred choice of treatment for internal hemorrhoids grades 2 and 3. Sclerotherapy and conservative treatment such as warm sitz bath are usually indicated for grade 1 hemorrhoids whereas hemorrhoidectomies are usually indicated for Grade 3 - 4 hemorrhoids. Your doctor will discuss with you about the most suitable treatment approach for you.
Here is a breakdown of the grading of internal hemorrhoids:
Grade 1- No prolapse (only prominent blood vessels
Grade 2- Prolapse upon bearing down (spontaneous reduction)
Grade 3- Prolapse upon bearing down (manual reduce)
Grade 4 - Prolapse with inability to manual reduce