Treatment Overview

Rubber band ligation is a procedure in which the hemorrhoid is tied off at its base with rubber bands, cutting off the blood flow to the hemorrhoid. This treatment is only for internal hemorrhoids.

To do this procedure, a doctor inserts a viewing scope (anoscope) into the anus. The hemorrhoid is grasped with a small tool. Then a device places a rubber band around the base of the hemorrhoid. The hemorrhoid then shrinks and dies and, in about a week, falls off.

A scar will form in place of the hemorrhoid. The scar will hold nearby veins so they don't bulge into the anal canal.

The procedure is done in a doctor's office. You will be asked if the rubber bands feel too tight. If the bands are extremely painful, a medicine may be injected into the banded hemorrhoids to numb them.

The procedure takes about 30 minutes. You can go home when it's done. Some people are able to return to regular activities right away. Others may need to take a few days off from work.

After the procedure, you may feel pain and have a sensation of fullness in your lower belly. Or you may feel as if you need to have a bowel movement.

Make sure not to lift anything heavy until you heal. It's also important not to strain when you have a bowel movement.

Treatment is limited to 1 to 2 hemorrhoids at a time if done in the doctor's office. Several hemorrhoids may be treated at one time if the person has general anesthesia. More areas may be treated at 4- to 6-week intervals.

What To Expect

After the procedure, you may feel pain and have a feeling of fullness in your lower belly. Or you may feel as if you need to have a bowel movement. This usually goes away after several days. You may need pain medicine during this time.

You may have a small amount of bleeding from your anus about 7 to 10 days after surgery, when your hemorrhoid falls off. This is normal.

Some people are able to return to regular activities right away. Others may need to take a few days off work.

You will need to avoid heavy lifting and straining with bowel movements while you recover.

Why It Is Done

Rubber band ligation is the most widely used treatment for internal hemorrhoids. If you still have symptoms after three or four treatments, surgery may be considered.

Rubber band ligation cannot be used if there is not enough tissue to pull into the banding device. This procedure is almost never appropriate for fourth-degree hemorrhoids.

How Well It Works

Rubber band ligation works for about 8 out of 10 people. People who have this treatment are less likely to need another treatment compared to people who have coagulation treatments. About 1 out of 10 people may need surgery.^{footnote 1}

Risks

Side effects are rare but include:

• Severe pain that does not respond to the methods of pain relief used after this procedure. The bands may be too close to the area in the anal canal that contains pain sensors.
• Bleeding from the anus.
• Inability to pass urine (urinary retention).
• Infection in the anal area.