Prolpased hemorrhoids that cannot be managed through simple home remedies and drugs should be removed either surgically or through non surgical procedures such as hemorrhoid banding and infrared coagulation. Compared to surgical procedures, less invasive procedures are preferred due to low risk of post operative complications.
What is hemorrhoid banding?
Hemorrhoid banding also known as hemorrhoid ligation or rubber band ligation is a less invasive procedure in which the base of the hemorrhoid tissue is tied with a special type of rubber band to cut off blood supply to the tissue. Due to lack of blood supply the tissue withers and falls off. It is a simple procedure and is generally done in the doctor’s office by giving local anesthesia. If more hemorrhoids are to be operated then it is performed in a way similar to surgery.
Who is the right candidate for rubber band ligation?
Rubber band ligation is performed in patients suffering with internal hemorrhoids, bleeding hemorrhoids, thrombosed hemorrhoids and prolapsed hemorrhoids. In Patients suffering with recurring hemorrhoids even surgery is performed to offer permanent relief. This procedure is generally not used for fourth degree hemorrhoids that have prolapsed extensively.
What does a physician do before performing hemorrhoid banding?
Before performing the surgery, physician will do thorough examination to rule out other conditions showing similar symptoms.
How hemorrhoid banding is performed?
To identify the root of the hemorrhoid vein, the doctor will do a thorough examination of the anal canal using an anoscope. After identifying the base of the hemorrhoid tissue it is held in position by holding through a banding instrument and rubber band is placed at the base of the tissue. As a result the tissue shrinks due to lack of blood supply. Within a week the inflamed tissue becomes dry and falls off. The procedure is painful. Depending on the severity of the pain complained by the patient, a medicine is injected in to the region to numb the area.
A modification of the rubber band ligation that is performed at doctor’s office is endoscopic ligation that is performed via endoscopy.
Benefits of endoscopic band ligation compared to rubber band ligation include:
- Endoscopic evaluation of the lower GI tract helps to identify other causes of anorectal bleeding such as anal fissures, rectal ulceration and other mucosal disorders.
- Can be performed more precisely than regular rubber band ligation.
- Multiple hemorrhoids can be ligated at a time. Thus, it needs less number of sessions compared to rubber band ligation.
- Less expensive compared to conventional rubber band ligation.
How patient feels after hemorrhoid banding
- A feeling of fullness.
- Urge to empty the bowels.
- Mild bleeding after about 7-10 days of performing the procedure. This is due to falling of the hemorrhoid tissue.
- Severe pain for about 24-48 hours.
Precautions to be followed after hemorrhoid ligation
Recovery depends on how the patient responds to the procedure. Few patients resume to normal activity almost immediately while few people need two to three days.
- To avoid the risk of complications such as bleeding and pain avoid lifting weights until the scar heals completely.
- Avoid taking non steroidal anti-inflammatory drugs such as aspirin for about four to five days before and after surgery to prevent the risk of bleeding.
- Take analgesics such as acetaminophen to relieve pain after ligation.
- Soak your bottom in warm water for about fifteen minutes to reduce discomfort.
- To prevent straining to pass the stools use stool softeners, take fiber rich diet and plenty of fluids.
- Avoid sitting for long hours.
Possible problems with hemorrhoid banding
A few patients may develop complications after the procedure. The percentage is low and if all precautions are taken the patient gets well very soon.
- Severe pain that does not subside with pain killers.
- Oozing of blood from anus.
- Retention of urine.
- Infections of the anus region.
- Recurrence of hemorrhoids.
- Reactions to anesthesia.
However, the risk of complications will be less if the procedure is performed by experienced physician. Hemorrhoid ligation is the preferred procedure compared to other expensive procedures and surgery. Consult the physician immediately if you suffer with complications such as extensive bleeding, pain in the region between genitals and rectum and if the problem of urine retention is severe.