Banding Hemorrhoids

By: Dr. Edward F. Group III, DC, Ph.D, ND, DACBN
updated on 06/06/2006 at 11:26AM

What is Hemorrhoids Banding?

Banding Hemorrhoids is the most commonly used procedure in the United States for the treatment of external hemorrhoids. Essentially, the hemorrhoid is tied off at its base with rubber bands, cutting off the circulation and causing the hemorrhoids to shrivel up. The hemorrhoid will then fall off on its own in about a week, usually during a bowel movement. A scar will form in the hemorrhoids place that will hold nearby veins in place and ensure that they don't bulge into the anal canal. Banding hemorrhoids is typically performed in a doctor's office on an out patient basis.

Advantages of Banding Hemorrhoids

Easy and Inexpensive: Banding Hemorrhoids is a simple procedure that is easy and inexpensive to perform, as it is done on an out patient basis. There is also no costly anesthesia or lengthy hospital stay required.
Fast Relief of Hemorrhoids: Banding Hemorrhoids provides more rapid and longer lasting relief of hemorrhoidal symptoms than injection sclerotherapy or infrared photocoagulation therapy.
Repeat Treatment is Rarely Needed: Most people who undergo the hemorrhoids banding procedure report improvement and do not need further medical treatment.

Disadvantages of Banding Hemorrhoids

Not As Effective on Large Hemorrhoids: Banding Hemorrhoids is not effective for treating third degree hemorrhoids or even bulky second degree cases.
Cannot Be Used For Multiple Hemorrhoids: Banding Hemorrhoids is limited to one to two hemorrhoids at a time if done in the doctor's office. Multiple hemorrhoids can be treated at once if the patient undergoes general anesthesia. Typically, your health care professional will treat additional areas at four to six week intervals.
Not A Hemorrhoid Cure: Banding Hemorrhoidsis not a cure for hemorrhoids and it is still possible for hemorrhoids to return at any time.

How Is Hemorrhoid Banding Performed?

Your health care provider will likely advise you not to take any medication that can cause bleeding, such as aspirin and coumadin. If you are taking steroid medications, have an immune system deficiency, or have an implanted prosthetic device, such as an artificial limb, your doctor will prescribe a preoperative antibiotic. You will then be given an enema to clear the rectum of any stool.

The most common position for this procedure is the left lateral position where you lay on you left side with your knees drawn to your chest and the buttocks projecting over the edge of the table. Once positioned, your health care provider will insert a warmed and lubricated proctoscope into the anal canal. Your doctor can then grasp the hemorrhoid with a forcep and pull it through the barrel of the ligator. The cylinder of the ligator is then pushed upward until it reaches the base of the hemorrhoid. Your doctor will squeeze the handle of the ligator to apply the rubber band to the base of the hemorrhoid. Your doctor may decide to use two hemorrhoid bands to protect against breakage and to ensure that circulation to the hemorrhoid is properly cut off.

Recovery From Banding Hemorrhoids

Mild aching and discomfort is common after the procedure, and can be treated with conventional or herbal pain relievers. You may also feel as if you need to have a bowel movement. Your health care provider may prescribe a lubricant suppository and a stool softener to prevent any straining during bowel movements that might further aggravate the sensitive area. You may experience rectal bleeding approximately seven to ten days after the procedure when the banded hemorrhoid falls off. The bleeding should be minimal and will stop on its own.

Risks Associated With Banding Hemorrhoids

Serious complications from banding hemorrhoids are rare, but they include:

Pain: Severe or sharp pain that occurs immediately after banding hemorrhoids is almost always caused by improper band placement. If this is the cause of pain, the band should be removed immediately and replaced at a location further above the dentate line. Mild pain or a feeling of pressure is normal and should subside within a few hours.
Bleeding: some bleeding may occur with the first bowel movement after banding hemorrhoids. Sever bleeding is very rare and occurs in less than one percent of cases in hemorrhoid banding.
Band slippage: If there is not enough hemorrhoid mass to hold the band in place, it is possible for band slippage to occur. Your health care provider may use two bands to avoid this complication.
Infection and Pelvic Sepsis: This is a rare complication but still very serious and potentially life threatening. Both cases should be immediately evaluated and treated by a medical professional.
Blood clot: In about five percent of cases, the patient may develop a very painful blood clot that requires surgery.
Anal fissure: Anal fissures develop in about one percent of cases as a result of the hemorrhoid sloughing off. Anal fissures may require prescription pain relievers and possibly surgery.

Effectiveness of Banding Hemorrhoids

Banding hemorrhoids is only effective for treating second degree hemorrhoids.

Who Should Not Try Banding Hemorrhoids

Banding hemorrhoids is not appropriate for treating third degree hemorrhoids or even complicated second degree cases. Hemorrhoids that have been previously treated with Sclerotherapy are difficult to band and should not be treated with this procedure. The product Hematrex can prevent Banding Hemorrhoids.