Rubber band ligation is an efficient and straightforward method of treating hemorrhoids. This procedure works by cutting off blood supply to the hemorrhoid, prompting it to shrink and eventually fall off.
At this stage, a doctor inserts a lighted tube (scope) into the anal canal and grasps the hemorrhoid with forceps before sliding the ligator’s cylinder upward to release rubber bands around its base and dissolve it.
What is Rubber Band Ligation?
Non-surgical treatment options for hemorrhoids
If home remedies and other treatment methods fail to help, rubber band ligation could be the answer. Your doctor uses rubber bands to seal off protruding internal hemorrhoids to stop its blood supply and wither and eventually fall off.
Rubber band ligation involves inserting a lighted tube (scope) down into your anal canal in order to identify hemorrhoids, then passing a tool called a ligator through the scope and grasping them with forceps before sliding the ligator’s cylinder upward to release rubber bands which tie around their base, cutting off circulation and eventually leading to their disappearance within weeks.
Doctors use injection sclerotherapy as another non-surgical procedure to treat hemorrhoids. Your physician injects medication that damages blood vessels within the hemorrhoid, restricting or stopping its blood flow and shrinking and drying out its mass.
Preparation for the procedure
Haemorrhoids can be treated using various surgical techniques, including open hemorrhoidectomy, stapled hemorrhoidopexy and Doppler-guided hepatic vein ligation.
Unfortunately, these methods have higher complication rates than non-surgical options like rubber band ligation; additionally they often result in post-procedure pain and anal strictures as well as possibly leading to recurrent hemorrhoids.
Rubber band ligation is an office-based procedure involving the application of xylocaine jelly and placing a rubber band ligator onto internal hemorrhoids in Grades 2 and 3. It is considered safe and effective treatment option.
Rubber band ligation is much less traumatic for patients than other office-based treatments, with complications typically limited to bleeding, pain, vaso-vagal symptoms, priapism and difficulty urinating occurring rarely. Nonetheless, they do arise and could include bleeding, pain, vaso-vagal symptoms and vasospasm along with difficulty in urination hesitancy.
These issues typically resolve within days as the hemorrhoids slough off and necrosis sets in; however, some patients experience persistent symptoms and require conventional surgery or hospitalization for hemorrhoidectomy (hemorrhoidectomy).
During the procedure
Procedure is performed in a doctor’s office under local anesthesia and involves lying down while being examined using a scope.
When viewing hemorrhoids, rubber bands will be applied and eventually, pressure or tightness may result, which should pass within several hours; call your physician immediately if any discomfort or bleeding arises from this procedure.
Rubber band ligation should only be performed on internal hemorrhoids, not Grade 4 hemorrhoids. In addition, warfarin or aspirin must not be taken for at least one week before or two weeks following this procedure.
Study results comparing suction ligation with forceps banding of second-degree hemorrhoids showed that suction ligation provided less postprocedure pain and bleeding while being more effective than forceps ligation; furthermore, suction ligation did not require sedation, providing another advantage to patients who may prefer anesthesia-free care.
Post-procedure
Healthcare is an individualized experience and each patient responds differently. While some may return to their regular activities (with the exception of heavy lifting) almost immediately after rubber band ligation, others may need an extended rest period.
When pain does arise from this procedure, taking an acetaminophen dosage or sitting in a shallow tub filled with warm water for 15 minutes at a time can help ease discomfort.
Minor complications associated with RBL are relatively frequent, including thrombosed prolapsed hemorrhoids in 4.7% and slippage of the bands in 1.7% of patients.
Unfortunately, severe complications requiring admission are less prevalent and include severe pain, bleeding, perianal abscesses, pelvic sepsis and fistula; all can be avoided through proper post-procedure care and early recognition of symptoms; reviews should be performed of both gastrointestinal tract and musculoskeletal systems to identify any abnormalities which require further evaluation.
Rare but Potential Complications
While complications associated with rubber band ligation are rare, it is essential to be aware of their possibility. These can include mild bleeding, pain, vasovagal symptoms, slippage of bands, priapism, difficulty urinating, and even sepsis.
It is crucial for clinicians to conduct a thorough examination of patients with anorectal complaints prior to proceeding with rubber band ligation. Failure to recognize a septic process in this area could result in fatal sepsis accompanied by extensive cellulitis and gangrene after the procedure.
In Conclusion
Rubber band ligation is a minimally invasive and highly effective treatment option for internal hemorrhoids that do not respond to home remedies. With its success rate ranging between 60% and 80%, this procedure offers a simpler and less painful alternative to surgical hemorrhoidectomy.
Although complications are rare, it is important to be aware of potential issues such as bleeding, pain, vasovagal symptoms, slippage of bands, priapism, difficulty urinating, and sepsis.
