Hemorrhoid Banding: Everything You Should Know

A hemorrhoid is a swollen blood vessel located inside the anus. While they’re relatively common in adults, they can be uncomfortable.

The good news is that most hemorrhoids can be treated at home. However, in cases where hemorrhoids do not respond to at-home treatments, surgery may be needed, with one of the most common surgeries being hemorrhoid banding.

Table of Contents

What Is Hemorrhoid Banding?

Hemorrhoid banding is a surgical procedure used to treat hemorrhoids by cutting off their blood supply, allowing them to shrink. It is completed when hemorrhoids are resistant to at-home treatments or are especially uncomfortable. 

In most cases, hemorrhoids can be treated with home remedies, such as cold compresses, high-fiber diets, and sitz baths. If these interventions do not work, your doctor may recommend an over-the-counter topical cream with ingredients such as witch hazel or hydrocortisone to further help relieve symptoms.

While these remedies typically work, hemorrhoids sometimes might not respond to them, or they may become increasingly painful and itchy. The hemorrhoids may even start to bleed, further increasing discomfort.

These types of hemorrhoids generally respond well to hemorrhoid banding, also known as rubber band ligation.

What Does the Hemorrhoid Banding Procedure Look Like?

Hemorrhoid banding is a minimally invasive surgery usually completed as an outpatient procedure, meaning you are able to return home afterward and do not have to stay in the hospital.

Before the procedure, you will be given a topical anesthetic to the rectum or, if you have many hemorrhoids or painful hemorrhoids, general anesthesia.

Once you have received the anesthetic or anesthesia, your doctor will insert an anoscope (a small tube with a light at the end) into the rectum until it reaches the hemorrhoid. Through the anoscope, they will then insert a ligator. Using the ligator, the doctor will place one or two rubber bands at the base of the hemorrhoid, repeating for any hemorrhoids that need treating.

In some cases, while performing hemorrhoid banding, your doctor may find blood clots in the hemorrhoids; if this occurs, they will remove them during the banding process.

The entire procedure usually takes only a few minutes.

Hemorrhoid banding is generally very straightforward, but it is often a good idea to have someone take you home and stay with you throughout the day to provide assistance around the house. The biggest reason for this assistance is to help prevent straining, which could result in complications.

What To Do After Banding a Hemorrhoid?

Following the banding procedure, you may feel some discomfort, including:

  • flatulence
  • abdominal swelling
  • abdominal pain
  • constipation

To help prevent bloating and constipation, your doctor may recommend a laxative or stool softener.

It’s also normal to notice some bleeding a few days after the surgery, but contact your doctor if it doesn’t stop after two or three days.

Within one to two weeks after your procedure, your hemorrhoids will dry up and fall off on their own. However, you likely won’t notice this occurring since they usually pass with a bowel movement.

What Are the Risks of Hemorrhoid Banding?

While hemorrhoid banding is a relatively safe procedure, there are a few risks associated with it, inclduing:

  • infection
  • excessive bleeding during bowel movements
  • fever and chills
  • recurring hemorrhoids
  • problems urinating

If you experience any of these symptoms, call your doctor right away.

FAQs

How painful is hemorrhoid banding?

Those who receive hemorrhoid banding often cite moderate discomfort and pain for the first 36-48 hours after surgery. In some cases, this pain may persist for a week or more.

During the procedure, if you are not under general anesthesia, your doctor may ask if the bands feel too tight. In cases where the bands are painful, the doctor may inject medicine into the hemorrhoids to help numb them.

How long does it take to recover from hemorrhoid banding?

Recovery from hemorrhoid banding differs by person. Some individuals may return to regular activities almost immediately, while others may need a few days of bed rest.

It is normal to feel pain for 24-48 hours after the procedure, and bleeding can occur 7-10 days after the procedure from the hemorrhoid falling off.

Can you poop after hemorrhoid banding?

It is safe to poop immediately after hemorrhoid banding, but it is important to avoid straining to help the area heal. Drinking more fluids and taking stool softeners are often recommended to ensure easier bowel movements.

How do you feel after hemorrhoid banding?

It is normal to feel pain after hemorrhoid banding and have fullness in your lower belly. Some people may feel as though they have to pass a bowel movement, but this sensation often goes away within a few days of the procedure.

How many hemorrhoids can be banded at once?

Hemorrhoid banding is typically done one hemorrhoid at a time. However, in the case of several hemorrhoids, up to three hemorrhoids can be treated at once, but you must be put under general anesthesia.

Are you awake during hemorrhoid banding?

For single hemorrhoid banding, you will be awake during the procedure and are given a topical anesthetic. However, if you are asleep during the procedure from general anesthesia, multiple hemorrhoids can be treated.

Does banding get rid of hemorrhoids permanently?

Banding removes the hemorrhoid, with the hemorrhoids falling off within a week or two of treatment. However, some people may have a hemorrhoid that regrows after treatment, requiring further treatment.

Key Takeaways

Hemorrhoid banding is a non-invasive procedure used to treat hemorrhoids where one or two rubber bands are placed at the base of the hemorrhoid, cutting off its blood supply. Within a few days, the hemorrhoid dries up and falls off.

Hemorrhoid banding is a quick outpatient procedure often completed with topical anesthetic or general anesthesia (in the case of multiple hemorrhoids). Most people experience pain for a few days following the procedure, along with a feeling of fullness in the lower abdomen.

Most hemorrhoids can be managed with at-home remedies and hemorrhoid banding is only necessary in extreme cases or instances of severe pain. If you are wondering about hemorrhoid banding for your hemorrhoids, ask your doctor if you are a good fit for this procedure.

Sources:

  • Watson, N., Liptrott, S., & Maxwell-Armstrong, C. (2006). A Prospective Audit of Early Pain and Patient Satisfaction Following Out-Patient Band Ligation of Haemorrhoids. The Annals Of The Royal College Of Surgeons Of England, 88(3), 275-279. doi: https://www.doi.org/10.1308/003588406×98649 
  • Albuquerque, A. (2016). Rubber band ligation of hemorrhoids: A guide for complications. World Journal Of Gastrointestinal Surgery, 8(9), 614. doi: https://www.doi.org/10.4240/wjgs.v8.i9.614 
  • Shanmugam, V., Thaha, M., Rabindranath, K., Campbell, K., Steele, R., & Loudon, M. (2005). Systematic review of randomized trials comparing rubber band ligation with excisional haemorrhoidectomy. British Journal Of Surgery, 92(12), 1481-1487. doi: https://www.doi.org/10.1002/bjs.5185 
  • Dekker, L., Han-Geurts, I., Rørvik, H., van Dieren, S., & Bemelman, W. (2021). Rubber band ligation versus haemorrhoidectomy for the treatment of grade II–III haemorrhoids: a systematic review and meta-analysis of randomised controlled trials. Techniques In Coloproctology, 25(6), 663-674. doi: https://www.doi.org/10.1007/s10151-021-02430-x 
  • Ding, Z., Xuan, J., Tang, G., Shi, S., Liang, X., An, Q., & Wang, F. (2022). Rubber band ligation versus coagulation for the treatment of haemorrhoids: a meta-analysis of randomised controlled trials. Postgraduate Medical Journal, postgradmedj-2022-141941. doi: https://www.doi.org/10.1136/pmj-2022-141941 
  • Komporozos, V., Ziozia, V., Komporozou, A., Stravodimos, G., Kolinioti, A., & Papazoglou, A. (2021). Rubber band ligation of symptomatic hemorrhoids: an old solution to an everyday problem. International Journal Of Colorectal Disease. doi: https://www.doi.org/10.1007/s00384-021-03900-2

DrHouse articles are written by MDs, NPs, nutritionists and other healthcare professionals. The contents of the DrHouse site are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.

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