Rubber Band Ligation
Overview:
Rubber band ligation is a convenient, non-surgical option for the treatment of internal hemorrhoids. To perform this in-office procedure, a provider inserts a viewing instrument called an anoscope into the anus. The hemorrhoid is then grasped with a suction device and a rubber band is applied to the base of the hemorrhoid. The hemorrhoids are then ligated at their base with the rubber band. This cuts off the blood supply to the hemorrhoid.
The hemorrhoid then shrinks, dies, and falls off in about a week. A scar will form in place of the hemorrhoid.
After the procedure, you may feel pain or discomfort and have a sensation of fullness in the lower abdomen. You may also feel as if you need to have a bowel movement. This is normal and should be temporary.
Treatment is limited to placing bands on anywhere from 1 to 3 hemorrhoids at a time. Taking too much tissue at one time increases risk of complications. Additional treatment may be performed at 6-week intervals, typically up to 3 times in office before discussion of surgical intervention is warranted.
Why It Is Done:
Rubber band ligation is the most widely used treatment for internal hemorrhoids. It is a simple, in-office procedure that allows for relatively quick treatment and can help some patients avoid the operating room and surgery. If you still have symptoms after three or four treatments, surgery may be considered. The most common procedures for hemorrhoids performed by Saint Alphonsus Medical Group Colorectal surgeons are excisional hemorrhoidectomy and trans-anal hemorrhoidal dearterialization (THD).
How Well It Works:
Rubber band ligation works for about 60% of people— with multiple treatments, success rates increase to about 80%. Approximately 1 in 10 people will require surgery.
Benefits:
Rubber band ligation is one of the most effective non-surgical treatments for internal hemorrhoids. Surgical removal of hemorrhoids (hemorrhoidectomy) may provide better long-term results (about 90% success rate) than fixative procedures such as rubber band ligation. However, surgery can be very painful, is more expensive, requires general anesthesia, requires a hospital visit, requires longer recovery times, and has a greater risk of complications. These are avoided with rubber band ligation.
Risks:
Side effects are rare but are important to be aware of. They include:
Severe pain that does not respond to the methods of pain relief used after this procedure. The bands may be too close to the area in the anal canal containing pain sensors.
Bleeding
Urinary retention
Fever
Infection
If you experience any of these symptoms, call our office at (208) 302-2400 or seek out emergency care at your closest ER.
What To Expect:
People respond differently to this procedure. You might experience some pressure or discomfort, but most people are able to return to their regular activities, including work, immediately. Others may need a few days of modified or light activity. Resume your normal diet. Pain or discomfort is expected for 24 to 48 hours after rubber band ligation. You may use over-the-counter acetaminophen (Tylenol) and sitz baths (submerging buttocks and hips in warm water) for comfort. Bleeding may occur 7 to 10 days after surgery, when the hemorrhoid falls off. Bleeding is usually light and resolves on its own.
For hemorrhoid prevention it is important to supplement your diet with adequate fiber and water. We recommend taking 1 tablespoon of psyllium husk (Metamucil) daily in addition to making sure you are drinking at least 64oz of water daily.
Follow up in clinic in 6 weeks to assess for improvement and determine if additional banding or other interventions are required.