Hemorrhoids are a common condition involving swollen veins in the lowest part of the rectum and anus. These vascular structures, which normally help with stool control, can become inflamed, leading to discomfort, bleeding, or itching. When lifestyle adjustments and over-the-counter remedies do not alleviate symptoms, rubber band ligation, often called hemorrhoid banding, is a common and minimally invasive treatment option.
Understanding Hemorrhoid Banding
Hemorrhoid banding, or rubber band ligation (RBL), treats internal hemorrhoids that cause symptoms. This method involves placing a small elastic band around the base of the hemorrhoid to restrict its blood supply. By cutting off the blood flow, the banded hemorrhoid tissue withers, shrinks, and effectively detaches within days. A small scar forms where the hemorrhoid once was, which helps anchor the surrounding tissue and reduce the likelihood of future hemorrhoid formation in that spot. This treatment is specifically applied to internal hemorrhoids, located above the dentate line in the anal canal, an area with few pain-sensing nerves.
The Banding Procedure: What to Expect
The hemorrhoid banding procedure is typically performed in a doctor’s office and generally does not require extensive preparation like fasting or bowel cleansing, nor does it usually involve general anesthesia. A healthcare provider inserts a viewing scope, an anoscope or proctoscope, into the anal canal to visualize internal hemorrhoids. Through the anoscope, a specialized ligator is used. Once the hemorrhoid is secured, a small rubber band is placed firmly around its base.
The entire process is quick, often taking only a few minutes. If multiple hemorrhoids require treatment, providers often band one or two at a time during separate visits to allow for adequate healing and to minimize discomfort.
Recovery and What to Expect After Banding
Following hemorrhoid banding, many individuals experience some discomfort, which can include a dull ache, a feeling of fullness in the rectum, or a sensation of needing to have a bowel movement. These sensations are temporary and subside within a few days. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, are typically sufficient to manage this discomfort.
As the banded hemorrhoid shrivels, it will detach and pass with a bowel movement within two to ten days. Minor bleeding or discharge is common when the hemorrhoid falls off, which should decrease over a few days. To support healing and minimize discomfort, it is advised to avoid straining during bowel movements, maintain a high-fiber diet, drink plenty of fluids, and use stool softeners if recommended by a healthcare provider.
Who is a Candidate for Hemorrhoid Banding?
Hemorrhoid banding is a widely used treatment for internal hemorrhoids when home remedies and lifestyle changes have not provided sufficient relief. This procedure is recommended for internal hemorrhoids causing symptoms like bleeding, pain, itching, or prolapse. It is effective for Grade I, Grade II, and some Grade III internal hemorrhoids. Grade I hemorrhoids bulge into the anal canal, Grade II protrude during bowel movements but retract spontaneously, and Grade III protrude and require manual repositioning. Banding is not used for external hemorrhoids due to their sensitivity to pain.