Rubber Band Ligation of Haemorrhoids

Rubber band ligation is a common procedure used to treat internal haemorrhoids, which are swollen veins in the lower rectum or anus. The procedure involves placing a small rubber band around the base of the haemorrhoid, cutting off its blood supply and causing it to fall off.

Indications

Rubber band ligation is typically used to treat internal haemorrhoids that are:

• Grade 1-3, meaning they are small to moderate in size and may prolapse during bowel movements but return to their normal position afterwards
• Causing symptoms such as bleeding, discomfort, or pain
• Not responding to conservative treatments such as dietary changes, fibre supplements, or over-the-counter medications

Procedure

The procedure is usually performed in a doctor's office or outpatient clinic and takes about 10-15 minutes. The steps involved are:

1. A rectal examination is performed to confirm the presence of internal haemorrhoids
2. A special instrument called a sigmoidoscope or anoscope is inserted into the anus to visualize the haemorrhoid
3. A small rubber band is placed around the base of the haemorrhoid, using a special device called a ligator
4. The rubber band cuts off the blood supply to the haemorrhoid, causing it to fall off within 1-2 weeks

Post-Procedure Care

After the procedure, patients may experience:

• Mild discomfort or pain, which can be managed with over-the-counter pain medications
• Bleeding, which is usually minor and temporary
• A feeling of fullness or pressure in the rectum

To minimize complications and promote healing, patients are advised to:

• Avoid heavy lifting, bending, or straining
• Take regular warm baths to help soothe the area
• Use stool softeners or fibre supplements to prevent constipation
• Avoid spicy or fatty foods that can irritate the rectum

Risks and Complications

While rubber band ligation is generally a safe procedure, there are some potential risks and complications, including:

• Bleeding or haemorrhage
• Infection
• Pain or discomfort
• Narrowing of the anal canal (stenosis)
• Recurrence of haemorrhoids

Success Rate

Rubber band ligation has a high success rate, with studies showing that:

• 70-90% of patients experience significant improvement in symptoms
• 50-70% of patients are completely cured after a single treatment session

Follow-Up Care

Patients typically require follow-up appointments to:

• Check for any complications or side effects
• Remove any remaining rubber bands
• Assess the effectiveness of the treatment and determine if additional sessions are needed