Rubber band ligation (RBL) is one of the common procedures to treat internal hemorrhoids in Minnesota. RBL, also called banding, is an office procedure in which the prolapsed hemorrhoid tissue is tied off at its base with rubber bands under anoscopy. It works very well for prolapsed hemorrhoids, such as the advanced grade 2 and grade 3 hemorrhoids. It cannot be performed if there is not enough tissue to pull into the barrel in the banding device. Therefore, this procedure is almost never appropriate for grade 1 or mild grade 2 hemorrhoids (treated with IRC), or most severe (grade 4) hemorrhoids (treated with surgery).

The process of banding involves a doctor inserting an anoscope into the anus and grasping the prolapsed hemorrhoid with a long clamp to place a rubber band around its base. With the rubber band in place, the hemorrhoid dies off in a few days or a week. The banding procedure is done in a doctor’s office and only a couple of minutes. Treatment is usually limited to 1 hemorrhoid each office visit and additional areas may be treated at 2 week intervals.

After the banding procedure, some patients may feel tightness, mild pain or have the feeling of bowel movement. Most patients are able to return to regular activities (but avoid heavy lifting) almost immediately. If you feel some pain after banding, you may use Tylenol or Ibuprofen as needed and do a lot of sitz bath for 15-30 minutes at a time to relieve discomfort. Some patients may have slight rectal bleeding in a few days or a week. If you notice significant rectal bleeding, then you should call your doctor’s office.

Some patients may need the combination of treatments with banding and infrared coagulation (IRC). They are treated with the banding first to downgrade their hemorrhoids, then IRC is used to treat the mild ones.