What is hemorrhoid rubber band ligation?

In this procedure, a hemorrhoid was tied off at its base with rubber bands.

You may feel pain and have a feeling of fullness in your lower belly. Or you may feel as if you need to have a bowel movement. This usually goes away within several days after the surgery. You may need pain medicine during this time.

You may have a small amount of bleeding from your anus about 7 to 10 days after surgery, when your hemorrhoid falls off. This is normal.

Some people are able to return to regular activities right away. Others may need 2 to 3 days of bed rest.

You will need to avoid heavy lifting and straining with bowel movements while you recover.

• Pain is likely for 24 to 48 hours after rubber band ligation. You may use acetaminophen (for example, Tylenol) and sit in a shallow tub of warm water (sitz bath) for 15 minutes at a time to relieve discomfort.
• Put ice or a cold pack on the area for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake). Put a thin cloth between the ice and your skin.
• Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position. This can make bowel movements easier after your procedure.
• If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative. Straining during bowel movements can cause hemorrhoids to come back.

It takes about 30 minutes.

Rubber band ligation works for about 8 out of 10 people. People who have this treatment are less likely to need another treatment compared to people who have coagulation treatments. About 1 out of 10 people may need surgery.

Preparing for the procedure

• You may need to empty your colon with an enema or laxative. Your doctor will tell you how to do this.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Side effects are rare but 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 that contains pain sensors.
• Bleeding from the anus.
• Inability to pass urine (urinary retention).
• Infection in the anal area.

Rubber band ligation treats hemorrhoids. Hemorrhoids are swollen veins in the rectal area. In most cases, this procedure can be done in the doctor's office. Your doctor can treat one or two hemorrhoids at a time. This treatment is only for internal hemorrhoids.

After the procedure, you may feel pain and have a feeling of fullness in your lower belly. Or you may feel as if you need to have a bowel movement. This usually goes away after several days. You may need pain medicine during this time.

You may have a small amount of bleeding from your anus about 7 to 10 days after surgery, when your hemorrhoid falls off. This is normal.

Some people are able to return to regular activities right away. Others may need to take a few days off work.

You will need to avoid heavy lifting and straining with bowel movements while you recover.

Rubber band ligation is the most widely used treatment for internal hemorrhoids. If you still have symptoms after three or four treatments, surgery may be considered.

Rubber band ligation cannot be used if there is not enough tissue to pull into the banding device. This procedure is almost never appropriate for fourth-degree hemorrhoids.

Your doctor will insert a viewing scope (anoscope) into your anus. The hemorrhoid is grasped with a small tool. Then a device places a rubber band around the base of the hemorrhoid. This stops blood flow to the hemorrhoids. The hemorrhoids shrink and fall off 7 to 10 days after the procedure.

You will be awake during the procedure. You may feel some discomfort. You will be asked if the rubber bands feel too tight. If the bands are too painful, a medicine may be injected into the banded hemorrhoids to numb them.

You will be able to go home right after the procedure.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the doctor's office

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider.
• The procedure will take about 30 minutes.
• You will be able to go home right after the procedure.