Rubber band ligation for hemorrhoids is a procedure that can be performed in a clinic consultation room without any need for sedation or painkillers. An anal probe is inserted to allow the doctor to visualize the hemorrhoids and determine which ones are causing your problem.
Everyone has 3 hemorrhoids and your doctor may choose to ligate up to three times depending on which one is causing your problem. The risks of rubber band ligation are related to whether the rubber band is applied correctly. Ideally, the rubber band should be applied in the upper anus as that is where the hemorrhoids are. When done correctly, the risk of infection is zero and risk of bleeding (needing medical treatment) is less than 1%.
If the rubber band is applied too deep into the rectum, the patient will not feel any discomfort but there is a risk of causing severe bleeding or pelvic infection about a week later. If the rubber band is applied in the lower anus, it causes immediate pain. The doctor will then have to remove the rubber band, which is technically very difficult.
If only one rubber band is applied, there is minimal discomfort and the patient will feel a slight urge to pass stools. This sensation disappears within a day. You may encounter some bleeding about 5 days later when the rubber band and the dead hemorrhoid drop off. That is normal. If two rubber bands are applied, the discomfort is magnified and the patient may need some mild painkillers for a few days. However, the patient is still comfortable enough to go about their daily activities. Applying 3 rubber bands causes significant tightening of the anus lining. It often causes pain and the patient will need to rest at home for at least 2 days.
I tend to ligate one or two hemorrhoids only at one time to minimize discomfort for the patient. It is also very rare for someone to have symptoms from all 3 hemorrhoids at the same time. If all your hemorrhoids are enlarged and prolapsing, you are likely to already have third degree hemorrhoids for which surgery will be a more appropriate treatment.
You should speak to your doctor about what stage your hemorrhoid is, what your treatment options are and their risks before you undergo rubber band ligation. When done appropriately, rubber band ligation for first and second degree hemorrhoids may prevent you having surgery in future from more advanced hemorrhoids.
