(Hemorrhoid Ligation; Rubber Band Ligation for Hemorrhoids)
Hemorrhoids are enlarged, bulging blood vessels in the anus and lower rectum. Hemorrhoid banding is a procedure to remove them.
Reasons for Procedure
Banding is used to treat painful, swollen hemorrhoids. The procedure is most often done for the following reasons:
- Severely bleeding hemorrhoids
- Severely painful hemorrhoids
- Hemorrhoid containing a blood clot (thrombosed hemorrhoid)
- Hemorrhoids that protrude through the anus (prolapsed hemorrhoids)
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Complications are rare, but no procedure is completely free of risk. If you are planning to have hemorrhoid banding, your doctor will review a list of possible complications, which may include:
- Recurrence of hemorrhoids
- Swelling and pain from remaining hemorrhoids
- Adverse reaction to the local anesthetic (if used)
What to Expect
Prior to Procedure
Your doctor may do the following:
- Physical exam
- Rectal exam
- Anoscopy—the visual examination of the inside of the anus using a short tube (anoscope) to help keep the sphincter open
- Sigmoidoscopy—the use of a specialized endoscope (a tube attached to a viewing device) to examine the inside of the anus, rectum, and lower intestine
Anesthesia is not usually needed. A local anesthesia may be used in some cases to numb the area.
Description of the Procedure
An anoscope will be inserted through the anus. The doctor will look through the tube to see inside the rectum and locate the hemorrhoid. A special banding tool will be used. The tool will place a small rubber band around the hemorrhoid. The band cuts off the blood supply. This will make the hemorrhoid fall off. More than one hemorrhoid may be banded. The band and the hemorrhoid will fall off in about 1 to 2 weeks.
How Long Will It Take?
This is a short procedure. The length of time depends on how many hemorrhoids need treatment.
Will It Hurt?
People often report some discomfort during and after this procedure. If you feel sharp or severe pain, tell the doctor right away. Mild pain medicine will help you manage discomfort during recovery.
For a few days, you may have difficulty controlling the passage of gas and bowel movements. When you return home after the procedure, do the following to help ensure a smooth recovery:
- 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.
- To prevent constipation and straining during bowel movements, use a stool softener, exercise, drink plenty of fluids, and eat plenty of high-fiber foods (such as fruits, vegetables, beans, and whole grains).
- Avoid heavy lifting for 2 to 3 weeks.
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
- Passing large amounts of blood
- Signs of infection, including fever and chills
- Pain that you cannot control with the medicines you have been given
- Constipation or trouble urinating
- An aching feeling develops in the area between the rectum and the genitals
If you think you have an emergency, call for emergency medical services right away.
American Society of Colon and Rectal Surgeons
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Digestive Health Foundation
Hemorrhoids. American Society of Colon and Rectal Surgeons website. Available at: https://www.fascrs.org/patients/disease-condition/hemorrhoids. Accessed October 3, 2017.
Hemorrhoids. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/hemorrhoids. Updated November 8, 2016. Accessed October 3, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Daus Mahnke, MD Last Updated: 10/14/2020