Banding of haemorrhoids

Banding of haemorrhoids (also known as rubber band ligation) is a common procedure for moderately sized haemorrhoids. The procedure is often combined with either a colonoscopy or a flexible sigmoidoscopy to ensure that there are no other abnormalities to account for the bleeding further along the bowel. Because banding of haemorrhoids is often combined with colonoscopy or flexible sigmoidoscopy, banding is often performed under sedation although it can usually be done comfortably in an awake patient.

The band is typically applied at the top part of the haemorrhoid above the anal canal. The band serves two purposes: to draw the haemorrhoid internally therefore preventing it from prolapsing down, and to create fixation of the haemorrhoid to the muscle underneath to prevent or decrease further prolapse and bleeding. Typically, between 2 and 4 bands are required to treat the haemorrhoids. It is not uncommon for patients to experience some degree of discomfort after application of the bands. Some patients may also experience the urge to defaecate and this is related to the bands drawing up haemorrhoids internally into the rectum creating a sensation of rectal fullness. These sensations usually pass after a couple of days.

Most banding is uncomplicated but minor bleeding can occur when the haemorrhoids separate from the anal canal between days 5 -7 after banding. Repeat banding procedure may also be required in some patients.

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