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Hemorrhoid banding treatment

What is hemorrhoid banding?

Rubber band ligation, also called banding, involves the application of a tight elastic band around the base of the hemorrhoid which cuts off the blood supply and results in the hemorrhoid dropping off after typically 10-14 days.

What does hemorrhoid banding treatment involve?

No preparation is required when banding hemorroids.  The procedure is non-invasive.  A proctoscope or endoscope is inserted into the patient’s bottom.  This allows a suction elastic band ligator or a forceps ligator to be used to facilitate the application the of a tight elastic band around the hemorrhoid.

The procedure itself takes a few minutes depending on the number of hemorrhoids, though it is generally accepted that no more than two at a time should be treated in order to minimise discomfort and the risk of bleeding. As an outpatient procedure, the treatment is performed without an anaesthetic.

In some cases, further banding treatments are required.

What are the risks with hemorrhoid banding?

The main issue is mild bleeding. A small amount is perfectly normal, especially after going to the toilet for the first time. If you experience heavy bleeding that does not stop, then you will need to visit the Accident & Emergency (A&E) department of your nearest hospital. Other after effects include pain, feeling faint, slippage of bands, priapism (erection of the penis not from stimulation but from altered blood flow to it), difficulty in urination, anal fissure and chronic ulceration, all considered as mild complications. More severe but uncommon complications include severe bleeding, severe pain, urinary retention needing catheterisation, pelvic sepsis and death. Secondary bleeding normally occurs 10-14 days after hemorrhoid banding, with those patients taking anti-platelet and /or anticoagulant treatments more at risk. Early reporting of complications is paramount to allow for early treatment and a favourable outcome.

After hemorrhoid banding treatment

Patients are normally advised to sit quietly to recover after the procedure for a period of 10-15 minutes before leaving the clinic or hospital, just in case patients feel a bit faint afterwards.  Typically, patients will experience a dull ache around their anus for 4 to 5 days. Ulcers can occur around the site of the hemorrhoid banding though these usually heal without further treatment.

Sources: 

Albuquerque A. Rubber band ligation of hemorrhoids: A guide for complications. World J Gastrointest Surg 2016 Sep27; 8(9): 614-620

Brown SR, Tiernan JP, Watson AJM, Biggs K, Shepherd N, Wailoo AJ, Bradburn M, Alshreef A, Hind D, and the HnbBLe Study Team. Lancet 2016 Jul 23; 388(10042): 356-364

McCloud JM, Jameson JS, Scott AN. Life-threatening sepsis following treatment for haemorrhoids: a systematic review. Colorectal Dis 2006 Nov; 8(9): 748-755

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