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Hemorrhoid Banding

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NYU Langone Hospital – Long Island

Mount Sinai Hospital, New York

Mount Sinai South Nassau

Mercy Medical Center

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What Is Hemorrhoid Banding?

While hemorrhoids are not a serious or life-threatening condition, having hemorrhoids can certainly affect one’s quality of life, as some hemorrhoids are extremely painful, uncomfortable or prone to bleeding. Having hemorrhoids is a very common condition and often is eradicated by over-the-counter treatments or by prescriptions from a doctor. However, sometimes hemorrhoids return or aren’t affected by home remedies or OTC medications. In these cases, your physician may recommend a procedure known hemorrhoid banding.

Hemorrhoid banding is an outpatient, nonsurgical procedure where healthcare providers use a suction device to remove internal hemorrhoids. A small rubber band is placed around the base of an internal hemorrhoid. The banding ensures that nerve endings do not feel pain during the procedure. Hemorrhoid banding  is very quick and is often completed within one to two minutes.

What Are Hemorrhoids?

Hemorrhoids, also known as piles, are veins that have become swollen and inflamed in the rectal area. There are two types of hemorrhoids, internal (which affects the rectum), and external (which affects the anus). Hemorrhoids can also prolapse, and these may bulge outside of the anus, causing severe pain. Some patients may feel no symptoms at all when they have hemorrhoids, while others may have uncomfortable and painful symptoms that may require treatment. Common symptoms of hemorrhoids include:

  • Anal itching
  • Rectal bleeding
  • Painful, hard lumps near the anus 
  • Pain in the anus, especially when sitting 

Hemorrhoids are more common with age, and approximately more than half of those over the age of 50 will experience them, however, they can affect patients of all ages. It’s estimated that 1 in 20 people have hemorrhoids that present with symptoms.

Rectal bleeding is one of the primary symptoms of hemorrhoids, but it can also be a sign of a different and more serious issue. Rectal bleeding is also a symptom of inflammatory bowel disease (IBD), such as Crohn’s disease and ulcerative colitis, as well as colorectal cancer. You should always consult your gastroenterologist for a checkup if you discover rectal bleeding or blood in the stool.

What Causes Hemorrhoids?

Any type of straining can cause hemorrhoids, putting pressure on the veins in your anus and rectum, which causes the area to become inflamed. Specific causes of hemorrhoids may be straining too hard to produce a bowel movement, significant weight gain or pregnancy, straining while weightlifting, and straining while lifting heavy objects. A low-fiber diet also contributes to the development of hemorrhoids and can also present in patients who have conditions that cause chronic constipation or diarrhea, such as irritable bowel syndrome (IBS).

What Happens if Hemorrhoids Are Left Untreated?

The most common issue when hemorrhoids are left untreated is the continuation of discomfort, pain, and itching in the anal and rectal areas. However, other conditions can develop from nontreatment in some cases, such as blood clots (external hemorrhoids), anemia, or skin tags.

What Are the Treatments for Hemorrhoids?

The first-line treatments for hemorrhoids are over-the-counter medications or home remedies. You can try adding more fiber into your diet (20 to 25g per day), soak the area in a sitz bath, drink more water, and use laxatives to soften stool. To relieve hemorrhoids, many patients also use OTC medications, such as witch hazel, lidocaine, and hydrocortisone.

If these attempts are unsuccessful within a week’s time, or you continue  to have pain and quality of life issues, your doctor may recommend a different treatment. Nonsurgical treatments include:

  • Banding 
  • Sclerotherapy (a chemical is injected into the area to destroy the swollen tissue)
  • Electrocoagulation (an electric current interrupts the blood flow to the hemorrhoid)
  • Infrared coagulation (a heated probe is inserted into the rectum to treat the area)

While rare, surgical treatments for hemorrhoids include hemorrhoidectomy (surgical removal) and hemorrhoid stapling, often used to treat prolapsed hemorrhoids.

How Does Hemorrhoid Banding Work?

Hemorrhoid banding is often recommended by doctors, as it is the least invasive treatment and very effective. The procedure is simple—your physician will place a rubber band at the base of your internal hemorrhoid using a suction device. You won’t feel pain because the ablation blocks the pain receptors. The banding cuts off the blood circulation to the hemorrhoid. Within a few days, the hemorrhoid will shrink and fall off naturally.

Is There Any Preparation for Hemorrhoid Banding?

The procedure can be performed in the doctor’s office or in the ambulatory endoscopy center. It can be performed in conjunction with other procedures such as an endoscopy or colonoscopy. The only preparation that is required is an enema before the procedure unless the hemorrhoid banding is being done with a colonoscopy in which case the colonoscopy preparation is adequate.

Are There Any Side Effects After the Procedure?

Most patients feel no side effects after the procedure and can return to normal activities even on the day of treatment. You likely won’t notice when the hemorrhoid falls off after it has shrunk; your symptoms will simply go away. Some patients may feel a sense of being full or an ache in the rectum afterward, but this can be treated with OTC analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs). Ablation can only remove one hemorrhoid at a time, so those who have multiple hemorrhoids must schedule a CRH procedure for each one to remove them all.