Hemorrhoid Banding (Rubber Band Ligation)

What is a hemorrhoid banding?

Hemorrhoid banding (rubber band ligation) is a treatment to shrink internal hemorrhoids. Hemorrhoids are swollen veins inside your rectum. They can cause symptoms like rectal bleeding, pain and itching.

The procedure involves your healthcare provider placing a rubber band around the base of the hemorrhoid, cutting off its blood supply. Without blood, the hemorrhoid shrinks and falls off.

Your healthcare provider may recommend a rubber hand ligation if:

• Hemorrhoids are causing uncomfortable symptoms
• At-home treatments like eating more fiber, avoiding straining to poop and using over-the-counter medications don’t help your symptoms

The procedure is only used for internal hemorrhoids and may not work for large hemorrhoids.

How should I prepare for a band ligation?

Your healthcare provider may give you instructions to follow before the procedure. It could include information about:

• Medications to stop taking
• Bowel preparation (emptying your colon)

Your provider may do one last examination of the hemorrhoid(s) before the banding procedure.

What happens during a band ligation?

Here is what you can expect from hemorrhoid banding:

1. Your provider inserts an anoscope into your anus (butthole). This is a thin, hollow tube with a light at the end.
2. They insert a tool called a ligator through the anoscope. A ligator has forceps (a scissor-like tool) on the end that allow your provider to grasp the hemorrhoid. It also has a cylinder with rubber bands on the end. Many providers use a suction device to “suck” the hemorrhoid into the cylinder.
3. Once they grasp the hemorrhoid with the forceps, your provider slides the cylinder up over the hemorrhoid. Then, they push the rubber bands off the cylinder onto the base of the hemorrhoid.
4. They’ll remove the ligator and anoscope from your anus.

The procedure takes less than five minutes. If you have several hemorrhoids, you may need a follow-up appointment to treat them. Your provider may only treat one or two hemorrhoids with banding at a time.

What happens after hemorrhoid banding?

The rubber band cuts off the hemorrhoid’s blood supply. This causes it to shrivel up and fall off, usually within one week. A scar will form where the hemorrhoid was.

Some other things you can expect after are:

• You may feel like you have to poop after the procedure. Ask your provider what to expect from your first bowel movement. They may suggest taking a stool softener to make it easier.
• It’s normal to feel a little pain or fullness in your lower abdomen. Ask your provider about your options for pain relief as you recover.
• You may notice bleeding from your anus when the hemorrhoid falls off.

You can usually go back to your usual activities right after hemorrhoid banding. Some people need to take it slow for a day or two.

How do you poop after hemorrhoid banding?

You poop normally after the procedure. Your healthcare provider may recommend ways to soften your stool to make bowel movements easier. This could include eating more fiber, drinking lots of water or using medication to soften your poop.

What are the benefits of hemorrhoid banding?

Hemorrhoid banding is a good option for shrinking internal hemorrhoids without surgery. Your provider can do it in their office. The recovery is also quick compared to other treatments for hemorrhoids.

How successful is hemorrhoid banding?

It’s generally successful, but factors like the size and severity of the hemorrhoid play a role. Most studies find it to be between 70% and 80% effective.

What are the risks of hemorrhoid banding?

Complications are rare but could include:

• Bleeding
• Infection
• Severe pain from the rubber band
• Difficulty peeing

There’s a chance that the treatment won’t work. If this is the case, your provider will recommend other options to remove internal hemorrhoids.

How long does it take to recover from hemorrhoid banding?

Recovery is usually quick. You may find it hard to poop or have excessive gas for the first few days. Here are some things you can do to help with your recovery:

• Don’t strain to have bowel movements or spend several minutes sitting on the toilet when you poop.
• Go to the bathroom as soon as the urge hits you.
• Avoid constipation by eating fiber-rich foods, drinking more water and taking stool softeners (if necessary).
• Don’t lift heavy objects for at least two weeks. This puts pressure on your rectum.

When should I call my healthcare provider?

Contact your healthcare provider if you have any of the following symptoms after a rubber band ligation:

• Bleeding from your rectum
• Fever or chills
• Severe pain
• Unusual discharge from your rectum