Anorectal Care

Rubber Band Ligation

 

What is rubber band ligation?
Rubber band ligation is a procedure where the hemorrhoid is tied off at its base with rubber bands, cutting off the blood flow to the hemorrhoid. This treatment is limited to 1 to 2 hemorrhoids at a time if done in the doctor's office. Additional areas may be treated at 3 to 4 week intervals.

The doctor inserts a viewing instrument into the anus. The hemorrhoid is grasped with an instrument, and a rubber band is placed around the base. The hemorrhoid shrinks and recedes, falling off in about a week. A scar will form in place of the hemorrhoid, holding nearby veins so that they don't bulge into the anal canal. After the procedure, you may feel pain and a feeling of fullness in your lower abdomen, or you may feel as if you need to have bowel movement.

What to expect after treatment?
People respond differently to this procedure. Some are able to return to regular activities (but avoid heavy lifting) almost immediately. Others may need 2 to 3 days of bed rest.

1. You'll probably feel pain for 24 to 48 hours after the procedure. To relieve discomfort, you can take mild pain relievers or sit in a shallow tub of warm water (sitz bath) for 15 minutes at a time.
2. To reduce the risk of bleeding, do not take non-steroidal anti-inflammatory drugs (NSAIDs) for 4 to 5 days both before and after rubber band ligation.
3. Bleeding may occur 7 to 10 days after surgery, when the hemorrhoid falls off. Bleeding is usually slight and stops by itself.
   You should take stool softeners containing fiber and drink more fluids to ensure smooth bowel movements. Straining during bowel movements can cause hemorrhoids to develop again.

Why is it done?
Rubber band ligation is one of the most popular treatments for internal hemorrhoids. If symptoms continue after three or four treatments, surgery may be the next option.

How well does it work?
Up to 80% of people who have gone through the procedure said their symptoms improved.
• Rubber band ligation provides more rapid and longer-lasting relief than other therapies.
• Repeat treatment for recurring symptoms is rarely needed.
• This procedure is most useful for small- to medium-sized internal hemorrhoids.
• The procedure is less likely to be successful for large hemorrhoids.

Any Risks?
Side effects are rare, but may include:
• Severe pain that won't go away even after various methods of pain relief are used. The bands may be too close to the area in the anal canal that contains pain sensors.
• Bleeding from the anus.
• Inability to pass urine (urinary retention).
• Infection in the anal area.