Hemorrhoid Banding Procedure Overview

According to a Mayo Clinic study, three-fourths of all adults will suffer from hemorrhoids at some point in their lives – and given the discomfort and embarrassment associated with hemorrhoids, it only makes sense to familiarize yourself with treatment options like the hemorrhoid banding procedure. 

While there are several other options for removing hemorrhoids, such as sclerotherapy and various forms of coagulation (destroying the hemorrhoid with heat), there may be no easier and more effective way than band ligation, a.k.a. the hemorrhoid banding procedure.

What makes banding one of the better choices for hemorrhoid removal? Well, quite simply, it involves the least pain and cost of hemorrhoid removal procedures and has been shown to result in a lower rate of hemorrhoid recurrence. Let’s take a deeper dive into the details of the hemorrhoid banding procedure.

What is hemorrhoid banding?

Ancient Greeks described a process of treating hemorrhoids by wrapping them tightly with a small cord, but modern hemorrhoid banding, or rubber band ligation, was first suggested by Dr. Paul Blaisdell in 1958. The outpatient procedure for hemorrhoid banding was refined in the following years, particularly when Dr. James Barron developed a medical tool called the “Barron band ligator” to isolate the hemorrhoid during the banding procedure so the elastic band could be applied more easily. 

In essence, the hemorrhoid banding procedure involves isolating the hemorrhoid by “pulling it away” from the rectal wall, then placing a very small elastic band around it. This band cuts off the hemorrhoid’s blood supply. Starved of blood, the hemorrhoid will dry out, wither, and usually fall away in a few days, though this may take as long as a week.

In 1997, Dr Patrick J. O’Regan refined the procedure by developing a gentle suction device to isolate the hemorrhoid during banding, replacing Barron’s tool. This modification greatly reduced both the amount of pain involved and the speed of the procedure, in addition to reducing the rate of complications. Modern hemorrhoid banding is a quick, nearly painless procedure which has a very high success rate and a low rate of complications. 

An alternate process for hemorrhoid banding involves an endoscope (a flexible scope). However, endoscopic hemorrhoid banding is a more complex, costlier, and generally more painful version of the procedure.

How long does hemorrhoid banding procedure take?

Hemorrhoid banding is a relatively quick procedure. Typically, a doctor can apply bands to one or two hemorrhoids in about 10 minutes, with the entire procedure taking at most a half-hour from beginning to end. 

Suppose a patient has multiple hemorrhoids in need of banding. In that case, follow-up appointments will usually be scheduled, as generally only one or two hemorrhoids at most will be treated in a single visit.

How painful is hemorrhoid banding?

Hemorrhoids themselves have few pain-sensitive nerve endings, though there may still be a low level of pain during and following the procedure. Most patients will experience a dull ache after a banding procedure, as well as a “full” feeling in the lower abdomen. 

This usually begins the moment the band is placed and will typically continue only for the first few days after the procedure. In some cases, however, this may persist until the hemorrhoid falls away, which can take as long as a week. Some activities may exacerbate this discomfort and should be avoided during the recovery time.

If you experience severe pain at the site of the banding, however, you should contact your doctor immediately. Be aware that certain painkillers, such as Aspirin, increase the likelihood of bleeding and should be avoided while recovering from hemorrhoid banding. Use only painkillers which are approved by your doctor for your recovery.

Are you awake during hemorrhoid banding?

Yes, you will be awake for a hemorrhoid banding. Patients are given only mild sedation for the procedure, as this allows them to communicate with their doctor during the procedure and provide important feedback on hemorrhoid location, band placement, and their level of discomfort while the band is being applied, which helps the doctor place the band more effectively. In some cases when a patient finds the procedure too painful, a local anesthetic may be used.

How long does it take to recover from hemorrhoid banding? 

Once the band is in place and the blood flow to the hemorrhoid cut off, it will usually dry out and fall away from the body after two or three days, being expelled with stool. 

Sometimes, it can take as long as a week for the hemorrhoid to fall off. Regardless, recovery is very quick once the hemorrhoid is gone, and patients can generally resume their normal routines in as little as 7 to 10 days after a banding procedure.

Hemorrhoid banding side effects 

The most evident side effect is pain during recovery, which occurs in up to half of patients. Minor bleeding is a more common side effect, generally due to the sloughing off of the hemorrhoid. 

The procedure can, in some cases, result in episodes of feeling faint, difficulty in urination, and in extremely rare cases, a rectal ulcer. In some rare cases, there are also complications from slippage of the band. 

Overall, complications from the hemorrhoid banding procedure are rare – the chance of complications for modern hemorrhoid banding procedures is as low as 1%. If you experience excessive bleeding or other, more severe symptoms, contact your doctor immediately.

In Conclusion

Hemorrhoids are an embarrassing and a painful fact of life. You have a 75% chance of suffering from them at some point, and many people will suffer from them more than once. 

Fortunately, modern medicine has given us options for treating this all-too-common malady – and there is perhaps a no better option than the hemorrhoid banding procedure. 

The ideal intersection of low cost, ease, and minimal pain and recovery time, it’s a near-perfect solution for this age-old problem. And that’s why understanding the hemorrhoid banding procedure is vital for any adult who might find themselves in need of release from the suffering of hemorrhoids.