Rubber band ligation is a common and effective outpatient treatment for internal hemorrhoids, particularly those that are too large to be treated with sclerotherapy or infrared coagulation. Hemorrhoids are swollen veins in the rectum or anus that can cause discomfort, itching, and bleeding.

Procedure Overview:

  • During rubber band ligation, a doctor places a small rubber band around the base of the hemorrhoid. This is typically done using a ligator, an instrument that grasps the hemorrhoid with forceps and slips the rubber band around its base.

  • The rubber band cuts off the blood supply to the hemorrhoid, causing it to shrink and, within a week or so, fall off.

  • The procedure is usually performed in a doctor’s office or a clinic and doesn’t require anesthesia, though some patients may receive a local anesthetic.

Indications:

  • Primarily used for internal hemorrhoids that have not responded to conservative treatments like dietary changes and over-the-counter remedies.

  • Particularly effective for small- to medium-sized hemorrhoids.

Effectiveness:

  • Rubber band ligation is generally very effective, with success rates in treating hemorrhoids reported to be as high as 80-90%.

  • In some cases, multiple treatments may be necessary.

Risks and Side Effects:

  • While generally safe, the procedure can cause discomfort or pain, particularly during the first 24-48 hours after treatment.

  • Other potential complications include bleeding, infection, and, in rare cases, a severe form of pelvic sepsis.

  • Some patients may experience a feeling of fullness or an urge to have a bowel movement after the procedure.

Aftercare:

  • Patients are usually advised to avoid strenuous activity for the rest of the day but can return to normal activities the following day.

  • Pain can be managed with over-the-counter pain relievers and sitz baths.

  • High-fiber diets and adequate hydration are recommended to prevent constipation and straining during bowel movements, which can exacerbate hemorrhoids.

Follow-Up:

  • A follow-up appointment is usually scheduled a few weeks after the procedure to check for complications and determine if additional treatment is needed.

Rubber band ligation is a quick, effective, and minimally invasive option for treating internal hemorrhoids. However, it's important for patients to discuss with their healthcare providers to determine the most appropriate treatment for their specific case.