Procedure to remove hemorrhoids, which are enlarged and bulging blood vessels in the anus and lower rectum. Banding cuts off the blood circulation to hemorrhoids, causing them to shrink and fall off. 

PARTS OF THE BODY INVOLVED

Rectum and anus

REASONS FOR PROCEDURE

Hemorrhoid banding is used to treat painful, swollen hemorrhoids. More than one hemorrhoid can be banded at the same time. The procedure is most often performed for the following reasons:

  • Severely bleeding hemorrhoids
  • Severely painful hemorrhoids
  • Hemorrhoid containing a blood clot (called thrombosed hemorrhoid)
  • Hemorrhoids that protrude through the anus (called prolapsed hemorrhoids)

RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE

Banding is not recommended for hemorrhoids that protrude and remain outside of the body.

WHAT TO EXPECT

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Rectal exam
  • Sigmoidoscopy or anoscopy - the use of a specialized endoscope (a tube attached to a viewing device) to examine the inside of the anus, rectum, and lower intestine

The day of your procedure:

  • Wear comfortable clothing that is easy to remove
  • Follow your doctor's instructions for pre-procedure care

During Procedure - Possibly anesthesia

Anesthesia - None or local

Description of the Procedure - The doctor inserts an instrument with a light and lens, called an anoscope, through the anus, which is held in position by an assistant. The doctor uses a special banding tool to place a small rubber band around the hemorrhoid. The band cuts off the blood supply, causing the hemorrhoid to shrink. The band and the hemorrhoid will fall off in about one to two weeks.

After Procedure - Avoid straining or bearing down

How Long Will It Take? This is a relatively quick procedure, but the length of time depends on how many hemorrhoids need treatment.

Will It Hurt? Patients often report some discomfort during and after this procedure. If you feel sharp or severe pain, tell the doctor immediately. Mild pain medication helps manage discomfort during recovery.

Possible Complications:

  • Infection
  • Excessive bleeding
  • If a local anesthetic was used, an allergic or other adverse reaction to the medication
  • Difficulty urinating
  • Scar tissue may make it more difficult to pass stool
  • Remaining hemorrhoids may become swollen and painful
  • Hemorrhoids may recur

Average Hospital Stay - None

Postoperative Care:

  • Expect some bleeding and discomfort
  • Take sitz baths as recommended. Sitz baths will help relieve discomfort and clean the area. For a sitz bath, sit in warm water for 10 to 15 minutes. Pat the area dry, do not wipe or rub vigorously. You may be advised to take a sitz bath every four hours and after every bowel movement. Devices are available to place on top of the toilet to make this process easier.
  • For a few days, you may have difficulty controlling passage of gas and bowel movements
  • Use a stool softener, exercise, drink plenty of fluids, and eat plenty of high-fiber foods (fruits, vegetables, beans, and whole grains) to prevent constipation and straining during bowel movements
  • 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
  • Apply creams or ointments as directed by your doctor
  • Avoid heavy lifting for two or three weeks

OUTCOME

Expect some bleeding when the hemorrhoid falls off, which should occur within one to two weeks after the rubber band was applied. The wound normally heals within two weeks. See your doctor for a follow-up three to four weeks after the procedure.

When you can return to work will depend on the demands of your job and can range from a few days to a few weeks.

CALL YOUR DOCTOR IF ANY OF THE FOLLOWING OCCURS

  • Passing large amounts of blood
  • Pain becomes more severe
  • An aching feeling develops in the perineal area, between the rectum and the genitals
  • Signs of infection, including fever and chills
  • Constipation or difficulty urinating
SOURCE:

American Society of Colon and Rectal Surgeons

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