Rubber band ligation
Aim of the procedure
Rubber band ligation is a procedure aimed at treating internal hemorrhoids by reducing their size and reinforcing their supporting tissue by causing a small scar to form at their tip.
The one-year success rate of this treatment is 90%, and closer to 70% over the long term. In case of recurring hemorrhoids, depending on their size and overall presentation, several treatment options are available: additional rubber band ligation, infrared photocoagulation or surgery.
What is rubber band ligation?
Rubber band ligation is performed at your doctor’s office. He or she uses an anosocpe (a narrow tube that is inserted into the anus) and a sterile instrument equipped with a small cylinder at its tip. This cylinder applies gentle suction to the hemorrhoid and a small area of the surrounding rectal lining, and places a rubber band at its base. This cuts off blood supply to the area, eventually causing the tissue to wither and fall off. The rubber band is then naturally eliminated by the body, leaving a small wound in its place that heals after two to three weeks. The procedure itself only takes a few moments. One or more rubber bands can be placed during a single session. One to three appointments spaced at least four weeks apart are generally required.
What to expect after the procedure
For a few hours following the procedure, you may feel some discomfort, the sensation of a “foreign body” or the need to have a bowel movement. If you experience any pain, analgesics such as paracetamol or non-steroidal anti-inflammatory drugs may be prescribed. Light bleeding is common in the first few days following the procedure.
What are the possible complications?
- Fainting may occur following the procedure. This is generally caused by a sudden, temporary drop in heart rate (vasovagal syncope).
- Two to fifteen days after the ligation, the scab will detach and fall, potentially causing bleeding. If you experience heavy, recurrent bleeding, this is a hemorrhage and medical attention is required. Because of this risk, you must avoid long-distance travel (especially by plane) for two weeks following the procedure and keep the emergency numbers provided by your practitioner on hand. In rare cases, patients need a transfusion or brief surgical intervention to stop the hemorrhage.
- In rare cases, patients develop an infection following the procedure. It is important to seek medical attention if you experience significant pain, which may be accompanied by a lump around the anus, fever and difficulty urinating.
What precautions should be taken?
- Inform your doctor if you take anticoagulants or antiplatelet drugs
- Antibiotics may be prescribed ahead of the procedure
- For two to three weeks following the procedure, do not let your stool get hard and avoid straining. A treatment adapted to your situation to ensure regular transit may be prescribed. Do not perform an enema without medical advice during this period.