Throughout the history of medicine, the ways of treating hemorrhoids have remained relatively similar. Hippocrates used various surgical methods, including ligature operation, excision, cautery, etc. These techniques have been carried out throughout history with slight modifications, but they serve as the foundation for all hemorrhoid surgeries now in use.

In addition, the fact that hemorrhoids are often addressed in ancient works shows the lasting impact that this condition has had on humankind. Like other surgical treatments, Rubber Band Ligation, one of the most popular hemorrhoid treatments, dates back to 1958 when Blaisdell first described the treatment for symptomatic internal hemorrhoids. However, it was later popularized by Barron in 1963. Later, laparoscopic surgeon Dr. Patrick J. O'Regan invented the disposable CRH O'Regan System in 1997, approved by the FDA as the ligator for treating hemorrhoids.

According to research published in the Journal Diseases of the Colon and Rectum, Hemorrhoid Banding works for around 8 out of 10 patients. Unfortunately, one in every ten individuals may need surgery to remove their hemorrhoids after having their hemorrhoids banded.

Rubber Band Ligation for Hemorrhoids – Treatment Overview

Hemorrhoids (HEM-uh-roids), often referred to as piles, are swollen, bulging veins that develop inside and outside the anus and rectum, causing discomfort. They can occur inside the rectum (Internal Hemorrhoids) or under the skin around the anus (External Hemorrhoids). An individual with internal hemorrhoids may be a suitable candidate for Hemorrhoid Banding.

Rubber Band Ligation is a treatment where rubber bands are used to tie off hemorrhoids at their base, cutting off the blood supply and allowing it to heal.

An anoscope (viewing tool) is inserted into the anus to perform the treatment further. An instrument and a device are used to hold and wrap a rubber band around the hemorrhoid’s base to keep it in place.

The hemorrhoid then shrinks and eventually comes off within a week. After the treatment, the area forms a scar that acts as a bandage, preventing adjacent veins from bulging into the anal canal. The entire operation is carried out in a doctor's office.

How to Prepare for Hemorrhoid Banding?

Rubber Band Ligation, also known as Hemorrhoid Banding, is a simple and quick surgery that your doctor can perform in a short amount of time. It is performed at your physician's office and can be completed in an hour or two, after which you can return home. Here's what you need to know to be prepared for your banding appointment:

• Make arrangements for someone to take you home since you won't be able to drive on your own due to the effects of anesthesia and heavy medication.
• Inform your doctor about all of the medicines and natural health products you use. Some of these medications may increase the possibility of complications during the procedure.
• Confirm that your doctor and the hospital have received a copy of your advance care planning document. If you don't already have one, consider filling out one. It allows the doctor to be aware of your healthcare preferences.
• Let your doctor know if you are taking aspirin or any other blood thinner and inquire whether or not you should stop taking it before your procedure. Make sure you understand everything that your doctor has instructed you to do.

What to Expect After the Treatment?

The outcome of Rubber Band Ligation is different for every patient. Some people can return to their usual activities (except for heavy lifting) soon after surgery. At the same time, others may need bed rest for two to three days. Pain lasts for 24 to 48 hours after the procedure.

To ease the pain, it is often recommended to take acetaminophen (Tylenol) or sit in a small tub of warm water (sitz bath) for 15 minutes (2-3 times a day). However, refrain from taking any nonsteroidal anti-inflammatory medicines (NSAIDs) or aspirin for 4 to 5 days before and after Rubber Band Ligation to reduce the risk of bleeding.

When the hemorrhoid is removed from the anal area, bleeding may occur for 7 to 10 days. A small amount of blood usually is shed but stops on its own. Doctors recommend stool softeners, fiber consumption, and drinking lots of water for smooth bowel movements.

How to Care for Yourself at Home?

After Rubber Band Ligation, some individuals can immediately return to their previous activities, while others may need two to three days of bed rest. Want to feel better soon? Follow the instructions outlined below:

• Gradually increase the amount of time you spend walking. Walking improves blood circulation and helps to avoid pneumonia and constipation.
• For 2 to 3 weeks, refrain from lifting anything that will put you under pressure. Do not participate in strenuous exercises such as weight lifting, bicycle riding, running, or aerobics until your doctor gives the go-ahead.
• If you have an upset stomach, consume basic, low-fat items such as plain rice, toast, yogurt, and boiled chicken. Drink lots of water to stay hydrated. Consume high-fiber meals after your surgery for frequent bowel movements.
• Apply ice or a cold pack to the affected region for 10 to 20 minutes, and try to do this every 1-2 hours. Make sure to use a small towel to prevent the ice from directly coming in contact with your skin.

The Final Cut

Hemorrhoid Banding is a painless procedure for removing hemorrhoids. An anoscope is used to insert the rubber band ligator into your anus (for internal hemorrhoids) and then pull the hemorrhoid away from the rectal wall before wrapping a rubber band around it. The band prevents blood from flowing to hemorrhoids, causing them to shrink and fall off.

Following the surgery, the hemorrhoids will dry up and fall out on their own. Hemorrhoids might take a week to two to dry up.

Banding is a safe and efficient treatment option for hemorrhoids. However, it may need to be repeated for recurring hemorrhoids. If you still have hemorrhoids after multiple attempts, you may require surgery to remove them permanently.