Rubber band ligation (RBL) is one of the common procedures to treat hemorrhoids in our clinic. RBL is an office procedure in which the prolapsed hemorrhoid tissue is tied off at its base with rubber bands. It works very well for prolapsed hemorrhoids, such as the advanced grade 2 and grade 3 hemorrhoids. It cannot be performed if there is not enough tissue to pull into the barrel in the banding device. This procedure is almost never appropriate for grade 1 or mild grade 2 hemorrhoids (treated with IRC), or most severe (grade 4) hemorrhoids (treated with surgery).
The 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. Treatment is usually limited to 1 hemorrhoid each office visit and additional areas may be treated at 2 week intervals.
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 for 15-30 minutes at a time 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.