Rubber band ligation (banding) is a common treatment used for moderate sized haemorrhoids. The procedure can often be performed in the office without the need for anaesthesia, as there are very few nerve endings in the bowel lining. Alternatively, banding may be performed at the time of colonoscopy.
Small rubber bands are applied to the haemorrhoid. The band constricts the blood supply to the haemorrhoid resulting in separation of the haemorrhoid. This typically occurs after 5-10 days.
Banding often produces an unpleasant sensation of needing to defaecate, and occasionally is very painful. The vast majority of patients are able to resume normal activities the day after the procedure. Banding may need to be repeated in 15-20% of patients.
Discomfort or a sensation of needing to use your bowels may be experienced after this procedure but significant pain is uncommon.
Local anaesthetic is sometimes used to provide pain relief but this will wear off over the next few hours. If you develop pain it is important to take some pain killers early so that it does not worsen. Unless otherwise directed you should use Panadol x2 every 4 hours with Ibupfrofen 400 milligrams every eight hours for the next 48 hours. You should check with your surgeon that it is appropriate for you to take Ibupfrofen. Oxycodone may be provided for stronger pain relief but this is sedating and may cause constipation. Pain does not usually last more than 48 hours. If it persists or becomes more severe contact your doctor.
Heat packs or hot baths often provide excellent pain relief.
Your bowels will continue to work normally after your banding. There is often a sensation of needing to open your bowels, even though there is nothing to pass. Do not continue to strain.
It is important not to try to empty your bowels within the first 2 hours after the banding, as there is a chance that the bands will fall off.
It is best to avoid becoming constipated as hard motions will increase your level of discomfort. Normafibe, one teaspoon twice daily may be used for the first week after surgery. It is common to experience discomfort with bowel movements for the first week or so after surgery. You may see blood on the toilet paper or in the bowl with the first few bowel motions.
When to contact your surgeon
If you experience a fever excessive bleeding, difficulty passing urine or increasing pain, you should notify your doctor as soon as practicable. It is normal to see small amounts of blood for a few days after the banding. Contact your doctor immediately if you experience heavier bleeding.