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Hemorrhoid Banding
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Hemorrhoid Banding

(Hemorrhoid Ligation)

En Español (Spanish Version)

Definition

This is a procedure to remove hemorrhoids , which are enlarged and bulging blood vessels in the anus and lower rectum. Banding cuts off the blood circulation to hemorrhoids, causing them to shrink and fall off.

Parts of the Body Involved

Hemorrhoid banding is done at the rectum and anus.

Reasons for Procedure

Hemorrhoid banding is used to treat painful, swollen hemorrhoids. More than one hemorrhoid can be banded at the same time. The procedure is most often performed for the following reasons:

  • Severely bleeding hemorrhoids
  • Severely painful hemorrhoids
  • Hemorrhoid containing a blood clot (called thrombosed hemorrhoid)
  • Hemorrhoids that protrude through the anus (called prolapsed hemorrhoids)

Grade 2 Hemorrhoid

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Risk Factors for Complications During the Procedure

Banding is not recommended for hemorrhoids that protrude and remain outside of the body.

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Rectal exam
  • Sigmoidoscopy or anoscopy—the use of a specialized endoscope (a tube attached to a viewing device) to examine the inside of the anus, rectum, and lower intestine
The day of your procedure:
  • Wear comfortable clothing that is easy to remove.
  • Follow your doctor's instructions for pre-procedure care.

Anesthesia

The procedure does not typically call for anesthesia, although a local anesthesia may be used in some cases.

Description of the Procedure

The doctor inserts an instrument with a light and lens, called an anoscope, through the anus, which is held in position by an assistant. The doctor uses a special banding tool to place a small rubber band around the hemorrhoid. The band cuts off the blood supply, causing the hemorrhoid to shrink. The band and the hemorrhoid will fall off in about one to two weeks.

After Procedure

Avoid straining or bearing down.

How Long Will It Take?

This is a relatively quick procedure, but the length of time depends on how many hemorrhoids need treatment.

Will It Hurt?

Patients often report some discomfort during and after this procedure. If you feel sharp or severe pain, tell the doctor immediately. Mild pain medication helps manage discomfort during recovery.

Possible Complications

  • Infection
  • Excessive bleeding
  • Allergic or other adverse reaction to the local anesthetic (if used)
  • Difficulty urinating
  • Difficulty passing stool due to scar tissue
  • Swelling and pain from remaining hemorrhoids
  • Recurrence of hemorrhoids

Average Hospital Stay

Hospital stays are not required after a hemorrhoid banding procedure.

Postoperative Care

  • Expect some bleeding and discomfort.
  • Take sitz baths as recommended. Sitz baths will help relieve discomfort and clean the area. For a sitz bath, sit in warm water for 10-15 minutes. Pat the area dry, do not wipe or rub vigorously. You may be advised to take a sitz bath every four hours and after every bowel movement. Devices are available to place on top of the toilet to make this process easier.
  • For a few days, you may have difficulty controlling passage of gas and bowel movements.
  • Use a stool softener, exercise, drink plenty of fluids, and eat plenty of high-fiber foods (fruits, vegetables, beans, and whole grains) to prevent constipation and straining during bowel movements.
  • Move your bowels as soon as you feel the urge.
  • Do not strain, bear down, or hold your breath during a bowel movement.
  • Do not sit on the toilet for long periods of time.
  • Apply creams or ointments as directed by your doctor.
  • Avoid heavy lifting for two or three weeks.

Outcome

Expect some bleeding when the hemorrhoid falls off, which should occur within 1 to 2 weeks after the rubber band was applied. The wound normally heals within two weeks. See your doctor for a follow-up 3 to 4 weeks after the procedure.

When you can return to work will depend on the demands of your job and can range from a few days to a few weeks.

Many people may continue to develop new hemorrhoids after the banding procedure.

Call Your Doctor If Any of the Following Occurs

  • Passing large amounts of blood
  • Pain becomes more severe
  • An aching feeling develops in the perineal area, between the rectum and the genitals
  • Signs of infection, including fever and chills
  • Constipation or difficulty urinating

RESOURCES:

American Society of Colon and Rectal Surgeons
http://www.fascrs.org

National Digestive Diseases Clearinghouse
http://digestive.niddk.nih.gov

CANADIAN RESOURCES:

Health Canada
www.hc-sc.gc.ca/index_e.html

Canadian Digestive Health Foundation
http://www.cdhf.ca/aboutcdhf.htm

References:

American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org/ .



Last reviewed November 2007 by A. Carmack, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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