: Rubber band ligation (RBL) is one of the common procedures to treat hemorrhoids. RBL is an office procedure that mainly treat the prolapsed hemorrhoids in the advanced grade 2 and grade 3 hemorrhoids.
RBL is very effective in treating hemorrhoids, but it is not very efficient because RBL treatment is usually limited to one hemorrhoid each office visit and additional areas may be treated at 2 week intervals. Most patients need 2-4 RBL sessions. The patients will have more rectal discomfort, rectal tenesmus (feeling of incomplete defecation), and pain if given the RBL in two locations at the same time.
The hemorrhoid tissue has to be prolapsed enough to be tied off at its base with rubber bands, so it cannot be performed if there is not enough tissue to be pulled into the barrel in the banding device. This procedure is almost never appropriate for grade 1 or mild grade 2 hemorrhoids. The infra-red coagulation (IRC) is the better option for early and mild hemorrhoids.
The RBL process involves a doctor inserting an anoscope into the anus and grasping the prolapsed hemorrhoid with a long clamp to place a rubber band around its base. With the rubber band in place, the hemorrhoid dies off in a few days or a week. The procedure is done in a doctor’s office and only a couple of minutes.
After the procedure, some patients may feel tightness, mild pain or have the feeling of bowel movement. Most patients are able to return to regular activities (but avoid heavy lifting) almost immediately. If you feel some pain after banding, you may use Tylenol or Ibuprofen as needed and do a lot of Sitz bath to relieve discomfort. Some patients may have slight rectal bleeding in a week. If you notice significant rectal bleeding, then you should call your doctor’s office.
