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Rubber Band Ligation for Hemorrhoids: Effectiveness

Hemorrhoids are swollen and inflamed venous plexus in and around the anus and the lower rectum. They can be internal or external, depending on the anal region where it occurs. Hemorrhoids develop typically as a result of excessive pressure on the veins during bowel movements. Pregnancy, sitting for long hours or diarrhea can also cause hemorrhoids. Common symptoms include bleeding, pain and itching. Although there are many effective home remedies to cure hemorrhoids, many cases end up in surgery because of worsening of the condition. If the problem persists even after taking precautionary measures, a doctor must be consulted at the earliest. Rubber band ligation is a popular treatment method for hemorrhoids.

What is Rubber Band Ligation?

Rubber band was first used for ligation of hemorrhoids by Blaisdell in 1958. This nonsurgical method is less painful compared to other surgical treatments of hemorrhoids. It is an outpatient procedure aimed at curing second-degree internal hemorrhoids. During the procedure, a small band is fastened at the base of the hemorrhoid restricting blood circulation to the hemorrhoidal mass. This causes the hemorrhoid to shrivel and dry in less than seven days. The withered hemorrhoid falls off along with the band during regular bowel movements. Rubber band ligation is performed in the doctor’s office. Patients may be given general anesthesia before starting the procedure. After diagnosing a patient for hemorrhoids, the doctor inserts an anascope, a viewing instrument, into the patient’s anus. This assists in grabbing the hemorrhoid and placing the rubber band. Patients are always asked if the rubber band is too tight. The doctor may inject a medicine into the banded hemorrhoids if the bands are too painful. Patients may feel pain, have an urge for a bowel movement or a feeling of fullness in the lower abdomen.

What to Expect After Rubber Band Ligation Treatment

Every individual does not respond in the same way to rubber band ligation. While some are able to get back to regular chores (except heavy lifting) right after the treatment, others may require bed rest for 2-3 days.

  • Patients are likely to experience pain for 1 to 2 days following rubber band ligation. Mild pain relievers can be consumed. Taking a sitz bath, i.e., sitting in a tub of warm water for at least 15 minutes three times a day helps relieve discomfort.
  • It is not a good idea to take aspirin or any other nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce the risk of bleeding for at least 4 days prior to and following rubber band ligation.
  • There may be bleeding from the affected area a week or more after the surgery, when the hemorrhoids wither away and fall off. However, this bleeding is almost negligible and stops on its own.

Health professionals recommend an increase the intake of fluids and consumption of stool softening foods, which contain fiber for smooth bowel movement. Straining during excretion can cause the hemorrhoids to recur.

How Well Rubber Band Ligation Works

The success rate of rubber band ligation is between 60 and 80%. Patients have experienced drastic improvement in their symptoms with this treatment. Moreover,

  • It is only rarely that a repeat treatment is required for recurring symptoms.

  • This procedure works the best in case of small to medium-sized internal hemorrhoids.

  • This is less likely to be successful for large hemorrhoids.

  • Cherry, blueberry and blackberry juices contain anthocyanins and proanthocyanins that help reduce hemorrhoidal pain and swelling by strengthening the hemorrhoidal veins.

Risks involved in Rubber Band Ligation

Rubber band ligation rarely has side effects, which may include

  • Bleeding from the anal canal

  • Infection inside the anal area

  • Difficulty in passing urine

  • Excruciating pain that may not be alleviated via traditional killers, subsequent to this procedure. The bands applied may be very near to the area in the anal canal that has pain sensors.

Rubber band ligation is one of the most inexpensive treatments for hemorrhoids that are very effective against Internal Hemorrhoids in the long run. If the symptoms keep recurring even after three or four treatments, is it advisable to consider surgery. In case the size of the tissue is too small to be pulled out and tied with a banding device, rubber band ligation cannot be performed. Moreover, this procedure is not ideal for fourth-degree hemorrhoids.