Rubber band ligation (RBL) is a common treatment method for hemorrhoids, especially prolapsed hemorrhoids, in Minnesota. This office procedure is almost never appropriate for grade 1 or mild grade 2 hemorrhoids (which are treated with IRC) or more severe grade 4 hemorrhoids (which are treated with surgery). RBL involves a doctor inserting a scope into the anus and clamping onto the prolapsed hemorrhoid to place a rubber band around its base, cutting off the blood flow to the hemorrhoid and causing it to shrink and die off. The procedure only takes a few minutes but is usually limited to one hemorrhoid per office visit. RBL downgrades hemorrhoids to grades 1 or 2, and any remaining hemorrhoids are typically treated with infrared coaguation (IRC).
What Happens After the Procedure?
After rubber band ligation, you’ll typically experience a bit of pain and a feeling of fullness in the lower abdomen, as well as an urge to have a bowel movement. These sensations are totally normal and usually subside within a few days. You may also experience small amounts of anal/rectal bleeding for about 7 days after procedure due to the hemorrhoid falling off. It’s encouraged to avoid physically intense activities that strain the body for at least 2-3 weeks. While some patients are able to return to regular activities immediately, others may need a couple days of downtime and bed rest.
Below are a few guidelines for navigating your post-rubber band ligation recovery process:
Avoid any strenuous exercises, such as biking/cycling, jogging, weight lifting, and aerobics, for 2-3 weeks or until your doctor gives you the green light.
Avoid lifting heavy objects for 2-3 weeks, including groceries, backpacks/briefcases, dog food, children, etc.
If you previously took any medications or blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, your doctor will let you know when it’s okay to restart your meds.
Take your post-surgery pain medications exactly as directed, but do not take two or more types of pain meds at the same time unless instructed to.
Take showers/baths as usual, but make sure to thoroughly dry the anal area dry.
Drink plenty of fluids, and eat lots of high-fiber foods to aid your bowel movements.
Take stool softener such as Colace to keep stool soft.
Try to avoid straining during bowel movements.
To speed up your recovery process, take a sitz bath (sit in 2-3 inches of warm water for 15-20 minutes) three times daily AND after bowel movements. Remember to pat the anal area dry afterward.
Call your doctor immediately if you cannot pass stools or gas, see bright red blood soaking through the bandage, or see signs of infection (increased pain, swelling, redness, pus draining from the area, fever).