Hemorrhoid banding is a specialized non-surgical therapy primarily used to treat internal hemorrhoids. It involves the use of rubber band ligation to isolate hemorrhoidal tissue from surrounding blood vessels. This method is suitable for patients with Grade I to III internal hemorrhoids and effectively alleviates symptoms such as bleeding, swelling, or prolapse, while avoiding the invasiveness and recovery period associated with traditional surgery. The procedure is typically performed in an outpatient setting, allowing patients to avoid hospitalization, making it a common choice in modern hemorrhoid treatment.
This therapy is a physical treatment that uses a specialized ligator to place a rubber band at the base of the hemorrhoid. The rubber band cuts off blood supply to the hemorrhoid, causing ischemic atrophy and eventual detachment of the tissue. The procedure lasts about 10-15 minutes and is usually performed in multiple sessions, targeting different hemorrhoid locations each time. The rubber band naturally falls off after about 5-7 days, and the atrophied tissue is absorbed by surrounding tissues, reducing the size of the hemorrhoid.
The mechanism combines tissue necrosis and fibrosis, effectively reducing swelling caused by blood stasis. This process induces a local inflammatory response, promoting the formation of new connective tissue, which helps secure the hemorrhoid in place and prevent prolapse.
Primarily suitable for Grade I to III hemorrhoids presenting with intermittent bleeding, swelling of hemorrhoidal nodules, or prolapse during defecation. It is mainly targeted at patients who do not respond to conservative treatments (such as medication or dietary modifications) or those who refuse surgery. This method is not recommended for external hemorrhoids or mixed hemorrhoids.
Indications include:
The treatment is performed in an outpatient setting with the patient in a lateral or knee-chest position. After locating the hemorrhoid with an anoscope, the physician precisely places the rubber band at the base of the hemorrhoid. Each session typically treats 1-3 hemorrhoidal sites, with treatments once a week, totaling 2-4 sessions for optimal results. The rubber band diameter is about 0.5-1 cm, and placement should avoid damaging the anal sphincter.
No anesthesia injection is required; only topical anesthetic gel is applied to reduce discomfort. Patients can resume daily activities immediately after the procedure, but strenuous exercise should be avoided for 24 hours. The rubber band usually falls off naturally after 3-5 days, and a slight ulceration at the treatment site is normal during healing.
Main advantages include:
Compared to conventional surgery, this approach preserves the normal anatomy of the anus and reduces complications such as anal stenosis. About 60-80% of patients experience significant symptom improvement, with long-term control of bleeding and prolapse.
Common side effects include:
Important Warning: If persistent bleeding, fever over 38.5°C, or severe swelling occurs, immediate medical attention is required. Patients with diabetes or on anticoagulants should adjust their medication dosage beforehand.
Contraindications include:
Post-treatment care instructions include:
This therapy can be combined with oral medications (such as anti-inflammatory drugs), but should avoid concurrent use with local anesthetics to reduce excessive numbness. Patients undergoing radiotherapy or chemotherapy should first evaluate their blood cell counts.
It has an additive effect with sclerotherapy, but the two treatments should be spaced at least 2 weeks apart. Compared to traditional surgery, this method does not affect subsequent surgical options and can be considered an upgraded treatment step.
Multicenter studies show that a single treatment has a success rate of about 65-75%, with a cumulative effectiveness of over 85% after multiple sessions. About 70% of patients experience no recurrence of symptoms within 6 months post-treatment, and long-term follow-up indicates good preservation of anal function over 5 years.
Compared to traditional rubber band ligation, modern improved devices allow for precise band placement, reducing the risk of accidentally ligating normal tissue. A 2019 Cochrane review confirmed that this method is superior to medication in improving bleeding symptoms.
Other non-surgical options include:
Surgical options include hemorrhoidectomy or stapled hemorrhoidopexy, suitable for severe Grade IV hemorrhoids or cases where other treatments have failed. The choice of method depends on hemorrhoid grade, symptom severity, and overall health status.
Pre-treatment bowel cleansing is required, usually involving laxatives or enemas to ensure the rectum is empty. The physician will explain the procedure in detail and confirm that the patient has no coagulation abnormalities or is not on anticoagulants. Patients with chronic illnesses such as heart disease or diabetes should inform the doctor in advance for risk assessment.
How long does discomfort last after treatment? How can it be alleviated?Discomfort or mild bleeding may occur 1-3 days post-treatment, which is normal. Pain relievers or topical anti-inflammatory suppositories can be used as directed. If bleeding is heavy or pain persists beyond 3 days, immediate medical attention is recommended to check for complications.
When can daily activities be resumed after treatment?Most patients can resume light activities within 24 hours, but lifting heavy objects or prolonged sitting should be avoided for at least one week. Sitz baths (2-3 times daily, 10-15 minutes each) are recommended during the first week to promote healing, and loose clothing should be worn to reduce friction.
What is the success rate of hemorrhoid banding?Clinical studies show that the immediate hemostasis success rate is about 90%, with approximately 70-80% of patients experiencing long-term symptom relief. However, if hemorrhoids are prolapsed or thrombosed, additional treatments such as hemorrhoidectomy may be necessary to improve outcomes.
How can diet help prevent recurrence after treatment?Increasing dietary fiber intake (such as whole grains and vegetables), drinking at least 1500cc of water daily to maintain bowel regularity, avoiding spicy foods and alcohol to reduce anal congestion, and regular exercise can promote intestinal motility and reduce constipation, thereby preventing hemorrhoid recurrence.
%201.svg)
Copyright © 2025 MedFrontiers. All Rights Reserved.
