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Understanding Haemorrhoid Banding

Haemorrhoid Banding is also known as “Rubber Band Ligation (RBL)” or “Piles Banding.” This is a simple and safe treatment for haemorrhoids. It does not require anaesthesia and can be done in the outpatient department. The doctor will tie a small rubber band around the base of the haemorrhoid to cut off blood flow. This helps shrink it and relieve haemorrhoids symptoms.

Haemorrhoids are a common issue that can cause a lot of discomfort. They’re like swollen veins inside the anus that can be painful. While they can be uncomfortable, they’re quite common in adults. In many cases, you can treat them at home. However, if they don’t respond to home treatments, you may need rubber band ligation.

Haemorrhoid Banding Treats:

Check Icon Internal Haemorrhoids
Check Icon Bleeding Haemorrhoids
Check Icon Prolapsing Haemorrhoids
Check Icon Discomfort and Pain from Haemorrhoids
Check Icon Recurring Haemorrhoids
 
 

Understanding Haemorrhoids (Piles)

Haemorrhoids

Haemorrhoids are swollen veins in and around the anus and lower rectum. They can be itchy, painful, and may bleed. There are different grades of haemorrhoids, from Grade 1 (internal, not prolapsed) to Grade 4 (prolapsed and cannot be pushed back in).

Grading of Haemorrhoids

Grade 1: These are internal haemorrhoids that don’t come out of the anus. They may bleed but are generally not painful.

Grade 2: These haemorrhoids come out of the anus during a bowel movement but then go back inside on their own.

Grade 3: These haemorrhoids come out of the anus and need to be manually pushed back inside.

Grade 4: These haemorrhoids are permanently prolapsed and cannot be pushed back in. They are often large, painful, and may contain a blood clot.

Here’s the Step-by-Step Banding of Haemorrhoid Procedure

Haemorrhoids

Step 1: Identifying the Haemorrhoid

  • A doctor will use a tool called an anoscope to look inside your anal canal.
  • They will locate the haemorrhoid that needs to be treated.
  • The goal is to find the haemorrhoid above the “dentate line”, which is an area that has very few nerves, making the procedure much less painful.

 

  • A doctor will use a tool called an anoscope to look inside your anal canal.
  • They will locate the haemorrhoid that needs to be treated.
  • The goal is to find the haemorrhoid above the “dentate line”, which is an area that has very few nerves, making the procedure much less painful.

  • Once the haemorrhoid is found, the ligator is carefully placed over it.
  • The tool works a bit like a suction device. It gently pulls the haemorrhoid into its tip.
  • This step is important to make sure the band goes to the correct area.

  • A small rubber band is released around the base of the haemorrhoid.
  • This band cuts off blood flow to the haemorrhoid.
  • Without blood, the haemorrhoid will shrink and eventually fall off in a few days.

  • Once the band is in place, the tool is removed.
  • The haemorrhoid stays inside with the band around it.
  • The treated haemorrhoid will dry up, shrink, and drop off naturally within about a week.
  • The small piece usually comes out during a bowel movement, and most patients don’t even notice when it happens.

Step 2: Positioning the Ligator

  • Once the haemorrhoid is found, the ligator is carefully placed over it.
  • The tool works a bit like a suction device. It gently pulls the haemorrhoid into its tip.
  • This step is important to make sure the band goes to the correct area.

Step 3: Applying the Rubber Band

  • A small rubber band is released around the base of the haemorrhoid.
  • This band cuts off blood flow to the haemorrhoid.
  • Without blood, the haemorrhoid will shrink and eventually fall off in a few days.

Step 4: After the Banding

  • Once the band is in place, the tool is removed.
  • The haemorrhoid stays inside with the band around it.
  • The treated haemorrhoid will dry up, shrink, and drop off naturally within about a week.
  • The small piece usually comes out during a bowel movement, and most patients don’t even notice when it happens.
Cured

Benefits of Haemorrhoid Banding

Painless Treatment

The procedure is done in an area with little sensitivity, so it's often not as painful as other treatments.

Non-Invasive

Haemorrhoid banding is a simple procedure that doesn't involve surgery and can be done in a doctor's clinic.

Quick Recovery

It has a shorter recovery time compared to surgical procedures and usually needs fewer treatments .

Long-Lasting Solution

Unlike over-the-counter creams that only provide temporary relief, haemorrhoid banding offers a long-term solution .

No Preparation Needed

No special preparation is needed, and you can drive home or return to work the same day .

Less Likelihood of Recurrence

Reduces the chances of haemorrhoids recurring by effectively removing the problem of haemorrhoids.

Treatment at a glance

Purpose

Purpose

Haemorrhoids and Piles
Procedure Duration

Procedure Duration

30 minutes
Anaesthesia

Anaesthesia

Not Required

Purpose

Haemorrhoids and Piles

Pain

Mild to moderate

Procedure Duration

30 minutes

Recovery Time

1 week

Drive

2 Weeks

Anaesthesia

Not Required

Recovery Time

Recovery Time

1 week
Pain

Pain

Mild to moderate
Drive

Drive

2 Weeks

Risks and Possible Complications of Haemorrhoid Banding

Rubber band ligation is considered a safe procedure, but like any medical treatment, it carries some risks. Knowing these upfront helps you feel prepared and know what’s normal versus when to call your doctor.

Possible side effects include:

  • Mild pain or discomfort for a few days after the procedure, which can be managed with over-the-counter pain relief.
  • Light bleeding around 2-4 days after treatment, often when the haemorrhoid falls off.
  • Feeling of fullness in the lower abdomen or the urge to pass stool.
  • Temporary swelling in the treated area, which usually settles on its own.

Rare complications:

  • Infection in the anal area.
  • Severe persistent pain that doesn’t ease with medication.
  • Heavy bleeding, often 10–14 days after the procedure.
  • Urinary retention, making it hard or impossible to pass urine.
  • Allergic reactions to materials or medicines used.
  • Slippage of the band before the haemorrhoid has fallen off.

If you notice severe pain, heavy bleeding, fever, or difficulty urinating, contact your doctor immediately.

Recovery Tips & Aftercare

Most people recover quickly from haemorrhoid banding, but following aftercare advice speeds healing and reduces the risk of problems.

For the first few days:

  • Avoid lifting heavy objects or straining during bowel movements.
  • Take short walks to keep blood flowing and prevent constipation.
  • Use warm sitz baths (10–15 minutes) to relieve discomfort and keep the area clean.

Diet & bowel health:

  • Eat high-fibre foods such as fruits, vegetables, whole grains, and legumes.
  • Drink 6–8 glasses of water a day to soften stools.
  • If recommended by your doctor, use a fibre supplement.

Pain relief:

  • Mild discomfort can be managed with paracetamol or ibuprofen.
  • Avoid aspirin unless your doctor has advised it, as it can increase bleeding.

Follow-up care:

  • The treated haemorrhoid will fall off within 7–14 days. You might see the band in your stool.
  • If further haemorrhoids need treatment, sessions are usually spaced 4–6 weeks apart.

Who Is the Right Candidate for Haemorrhoid Banding?

Rubber band ligation works best for certain types and grades of haemorrhoids. Your doctor will assess your condition during the consultation.

You may be a good candidate if:

  • You have internal haemorrhoids (grades 1 to 3) that bleed or prolapse.
  • You have tried home treatments (creams, sitz baths, dietary changes) without lasting relief.
  • You want a non-surgical option with a quick recovery.

You may not be suitable if:

  • You have external haemorrhoids or very advanced (grade 4) haemorrhoids.
  • You have certain bleeding disorders or are on blood-thinning medication.
  • You have inflammatory bowel disease or an active anal infection.

A consultation will confirm whether rubber band ligation is the best option or if another treatment would be more effective.

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Frequently Asked Questions

01. How long does rubber band ligation take to work?

During rubber band ligation, a tight rubber band is placed around haemorrhoid to cut off its blood supply. The haemorrhoid will shrink and fall off within 7 to 14 days. During this time, you might notice the small rubber band in your stools and experience some minor bleeding.

02. Is haemorrhoid banding painful?

Haemorrhoid banding is not painful, as the band is placed in an area where there are no pain-sensing nerves. However, some techniques may cause more pain after the procedure than others.

03. Can haemorrhoids go away on their own?

Small haemorrhoids may go away by themselves within a few days without treatment, but larger ones may require treatment as they typically cause discomfort.

04. How many haemorrhoids can be banded at once?

A doctor can treat one or two haemorrhoids at a time in their clinic. If needed, more haemorrhoids can be treated while the patient is under anaesthesia, and the procedure usually takes about 30 minutes.

05. What size haemorrhoids require surgery?

Enlarged grade 3 or grade 4 haemorrhoids that protrude often require surgical treatment, including haemorrhoidectomy or stapled haemorrhoidopexy.

06. Is haemorrhoid banding safe?

Rubber band ligation is considered a safe and effective procedure for haemorrhoids, with severe complications being rare. However, it’s important for the doctor to thoroughly understand the patient’s medical history before performing the procedure.

07. Do haemorrhoids bleed after banding?

After haemorrhoid banding, you may experience some tenderness and bleeding during your first bowel movement, which usually occurs about 2 days after the procedure.

08. Can haemorrhoids still swell after banding?

Swelling of the skin around the area may occur after the procedure, but it can be relieved with warm baths and hydrocortisone ointment. If the swelling is severe and the pain is intense, contacting the doctor is advised. Generally, 2-4 treatments are necessary to eliminate all internal haemorrhoids.
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