Hemorrhoid Banding: What You Need to Know

Hemorrhoids are swollen veins that develop around the anus or inside the lower rectum. If you have recurring hemorrhoids that cause discomfort, you may want to consider medical treatment.

Surgeons use a surgical procedure called hemorrhoid banding to treat internal hemorrhoids (those located in the rectum). The treatment is also known as rubber band ligation. The medical procedure also helps prevent them from coming back. 

This article takes a closer look at the hemorrhoid banding procedure along with alternative treatments for hemorrhoids. 

Man with roll of toilet paper in bathroom

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What Is Hemorrhoid Banding?

Hemorrhoid banding is a medical procedure used to treat internal hemorrhoids. According to a 2019 study, banding is an effective and inexpensive way to treat hemorrhoid symptoms.

Your doctor may recommend a banding procedure if you have internal hemorrhoids that:

  • Bleed a lot
  • Are very painful
  • Have a blood clot
  • Are protruding from the anus

Risk Factors for Hemorrhoids

You’re at higher risk for developing hemorrhoids if you:

  • Regularly experience constipation or diarrhea
  • Have a family history of hemorrhoids
  • Are between the ages of 45 and 65
  • Often spend too long on the toilet
  • Are pregnant
  • Participate in activities that cause you to strain (e.g., lifting weights)

Preparation

Before the procedure, a healthcare provider will likely ask you the following questions:

  • Do you have any allergies?
  • Are you taking any medications or supplements?
  • Is someone available to pick you up after the procedure?

A Fleet's enema may be given before the procedure.

Procedure

Healthcare providers typically perform this procedure in an outpatient setting, often right at the medical office. 

During a hemorrhoid banding procedure, a surgeon will place a rubber band around any hemorrhoids inside your rectum. This cuts off blood flow, which shrinks the hemorrhoid, eventually causing it to disappear completely.

To perform the rubber band procedure, your healthcare provider will insert a special rubber banding tool through a speculum to band the hemorrhoid at its base. They may use a suction device or forceps to hold the hemorrhoid in place and place the rubber band. 

Your doctor will use a local anesthetic to minimize pain during the procedure and immediately afterward. They may also prescribe you a topical ointment to help with post-operative discomfort. 

The procedure likely won’t last very long, but timing depends on how many hemorrhoids you have.

Recovery

It usually takes about a week for the hemorrhoid tissue to die and fall off.

In the meantime, you can expect some amount of pain in the week after the procedure. This will vary from person to person since we all have different pain thresholds. You may also feel a sense of anal fullness. Bleeding can also occur.

You may find it helpful to take over-the-counter (OTC) Tylenol (acetaminophen) to minimize any pain or discomfort you have after the banding procedure. Nonsteroidal anti-inflammatory drugs such as Advil (ibuprofen), Aleve (naproxen), and aspirin should be avoided for four to five days before and after the procedure as they may increase the risk of bleeding.

Another option for minimizing discomfort is to sit in a shallow tub of warm water, also known as a sitz bath. Taking stool softeners, staying well hydrated, and eating plenty of fiber can also help make bowel movements less painful.

It may take up to two weeks to heal and recover in some cases. And depending on the size and severity of the hemorrhoids, you may require multiple banding treatments to get rid of them entirely.

Risks

Early potential complications of this procedure include:

  • Abscesses (walled off areas of infection)
  • Heavy bleeding 
  • Peritonitis (inflammation of the lining of the abdominal cavity and organs)
  • Sepsis (a severe reaction to a blood infection)
  • Infection 

In the long-term, risks can also involve:

  • Recurring hemorrhoids 
  • Skin tags (growths of excess skin around the anus)
  • Bleeding
  • Constipation (infrequent bowel movements) or fecal incontinence (unable to control defecation)
  • Anal stenosis (narrowing of the anal canal that makes it harder to pass stool)

Who Should Not Get This Procedure

Because complications may be more likely in people with certain conditions. Your healthcare provider may recommend alternative treatments if you:

  • Have a compromised immune system
  • Are taking blood thinners
  • Have Crohn’s disease (an inflammatory bowel disease)
  • Have an existing infection in the area 

In some cases, the procedure may not be possible if there’s not enough tissue to apply a rubber band.

Alternative Treatments

If at-home treatment and lifestyle changes don’t help your condition, your doctor may recommend the following medical treatments for hemorrhoids.

Electrocoagulation

This procedure is also known as infrared photocoagulation. It involves using an infrared light beam to burn off internal hemorrhoids. 

Electrocoagulation may be less painful than rubber band ligation because your doctor will need to perform less tissue manipulation during the procedure. However, evidence suggests that electrocoagulation isn’t as effective and may have a higher failure rate than banding.

Sclerotherapy

This procedure involves injecting the vessels with a chemical solution to shrink and eliminate internal hemorrhoids.

Surgical Removal

Surgery (hemorrhoidectomy) is the most invasive procedure for treating hemorrhoids but is intended to eliminate them permanently. Surgeons typically perform this type of removal for hemorrhoids that have prolapsed (protruded from the anus) or very large external hemorrhoids that other treatments haven’t helped.

Summary 

Hemorrhoid banding is an effective and non-invasive way to treat internal hemorrhoids. It can be done as an outpatient procedure in your healthcare provider's office. Banding cuts off circulation to hemorrhoids. The banded portion eventually falls off within a week, leaving you hemorrhoid-free.

You may experience some pain and discomfort during and after the procedure. For most people, healing takes about a week or so. 

A Word From Verywell

While hemorrhoids are generally nothing to worry about, they can cause discomfort. Banding is an effective way to treat internal hemorrhoids that are causing you grief.

Knowing what to expect from the banding procedure can make it less nerve-wracking. If you have any additional questions about what to expect, don’t hesitate to talk to your healthcare provider. 

Frequently Asked Questions

  • How much does hemorrhoid banding cost?

    According to a 2019 study, the average cost of hemorrhoid banding is about $723.

  • How painful is hemorrhoid banding?

    You can expect some degree of pain and discomfort during the procedure and recovery period. This will depend on the person. Ask your healthcare provider about whether a local anesthetic is a possibility. They can also prescribe topical creams to help with any post-procedure pain. 

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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