Hemorrhoids are a common condition involving the swelling of vascular cushions in the lower rectum and anus. They are classified as external (below the anal opening) or internal (inside the rectum). Rubber Band Ligation (RBL) is a popular, minimally invasive outpatient treatment specifically designed for symptomatic internal hemorrhoids. This technique works by cutting off the blood supply to the affected tissue, causing it to shrink and fall away.
How Long the Banding Procedure Takes
The time required for a single rubber band ligation procedure is brief. Preparation and patient positioning take the most time, while the actual banding is swift. Once the hemorrhoid is isolated using an anoscope, applying the band takes only a few seconds.
The total time a patient spends in the procedure room is typically between five and fifteen minutes. Some modern suction-based ligation systems can complete the entire process in under a minute. Since general anesthesia or sedation is not required, patients can leave the clinic and resume most normal activities immediately following the visit.
The Immediate Recovery and Healing Timeline
Recovery begins with mild discomfort following the procedure. For the first 24 to 48 hours, patients may report a dull ache, a feeling of fullness, or a sensation similar to needing to pass stool. This pressure is caused by the band constricting the tissue and is usually managed with over-the-counter pain relievers. The discomfort typically subsides as the banded tissue starts to undergo necrosis due to the loss of blood flow.
The banded hemorrhoid tissue detaches along with the rubber band. This process most often occurs between three and ten days after the ligation. Patients frequently do not notice the passage of the tissue, as it is usually expelled during a normal bowel movement. A small amount of bleeding may be seen when the tissue falls off, which is a normal sign of success.
Once the banded tissue has separated, a small wound remains in the rectal wall. This wound usually takes one to two weeks to heal completely. During this period, maintaining soft bowel movements and avoiding straining is important to allow the area to fully regenerate healthy tissue.
Determining the Total Number of Treatment Sessions
A single banding appointment is rarely sufficient because internal hemorrhoids typically occur in three main columns. To minimize pain and complications, medical guidelines recommend treating only one hemorrhoid column per visit. This approach, known as staging the treatment, prioritizes patient comfort and safety.
The total number of sessions required usually ranges from two to four, depending on the number and size of the hemorrhoids needing treatment. The interval between these appointments allows for complete healing from the prior ligation. Most practitioners schedule follow-up banding sessions between four and eight weeks apart.
This staggered approach means a complete RBL treatment plan can span several months. For example, a patient requiring three sessions spaced six weeks apart would complete their treatment course in approximately 12 weeks. This extended duration ensures each treatment site is fully healed before the next is addressed.
Longevity of Results and Preventing Recurrence
Once a full course of rubber band ligation is completed, the results are long-lasting. Studies show that patients can expect the benefits to persist for four to five years or more. However, RBL treats the hemorrhoid itself and not the underlying biological factors that led to the condition.
Recurrence rates are low, with studies indicating the likelihood of hemorrhoids returning is around 13 to 17% at the five-year mark. To ensure long-term effectiveness, specific lifestyle adjustments are necessary. Preventing future hemorrhoid formation depends on avoiding excessive pressure and straining during defecation.
A high-fiber diet, adequate daily water intake, and the use of fiber supplements are recommended to keep stools soft and easy to pass. By committing to these dietary and lifestyle changes, patients significantly reduce the likelihood of recurrence, maximizing the duration of the positive results achieved through banding.