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What is Hemorrhoidal Band Ligation?

Hemorrhoidal band ligation, which is also known as rubber band ligation is a procedure that involves tying the hemorrhoid at its base with a rubber band, cutting off the blood flow to the hemorrhoid. This procedure is performed only for internal hemorrhoids.

Hemorrhoidal Band Ligation

Indications for Hemorrhoidal Band Ligation

Hemorrhoids are areas of swollen veins in the lower rectum which can be uncomfortable and tend to bleed. They may be treated by eating a high-fiber diet, use of cold compresses, sitz baths, and topical creams. Hemorrhoidal band ligation is indicated if these treatments fail to resolve the condition.

Contraindications for Hemorrhoidal Band Ligation

Hemorrhoidal band ligation may be contraindicated if there is not enough hemorrhoidal tissue to pull into the banding device or if the hemorrhoid permanently bulges out of the anus.

Preparations for Hemorrhoidal Band Ligation

  • You should inform your doctor of any medications, vitamins, or supplements that you are taking.
  • Avoid food and drink for several hours before the procedure.
  • Arrange for someone to drive you back home after the procedure.
  • Stop smoking/drinking alcohol for a few days prior to the procedure.

Hemorrhoidal Band Ligation Procedure

  • The procedure is performed under local or general anesthesia, or a topical anesthetic may be applied. 
  • Your doctor will insert an anoscope into your rectum until it reaches the hemorrhoid.
  • Then a small tool called a ligator will be inserted through the anoscope to grasp the hemorrhoid with forceps. 
  • Sliding the ligator's cylinder upward releases rubber bands around the base of the hemorrhoid.
  • The rubber bands cut off the hemorrhoid's blood supply, causing it to wither and eventually drop off.

Postoperative Care

After the procedure, the hemorrhoids will eventually dry and fall off. This can happen between one and two weeks. The doctor may recommend taking a laxative to help prevent constipation and bloating. You may also observe some bleeding for a few days after the procedure which is completely normal, but you should contact your doctor if it is excessive or doesn’t stop after two or three days.

Risk and Complication

Hemorrhoid banding is a relatively safe procedure. However, there are risks and complications that could occur, such as:

  • Infection
  • Bleeding during bowel movements
  • Problems urinating
  • Recurring hemorrhoids
  • Fever and chills

Prognosis of Hemorrhoidal Band Ligation

Hemorrhoidal band ligation is a very effective non-surgical treatment for internal hemorrhoids. Most patients that undergo the procedure achieve long term relief of symptoms and do not require any other treatment.

  • The University of Texas Health Science Center at Houston
  • Baylor College of Medicine
  • Baylor University
  • Houston Methodist, Houston
  • American College of Gastroenterology