What is rubber band ligation?
Rubber band ligation (RBL) is placement of small rubber band around enlarged internal haemorrhoids. It causes the enlarged part of the haemorrhoid to shrink.
How is it placed?
An instrument is placed into the anal canal (a proctoscope) and a rubber band applicator is used to pick up the haemorrhoid and place the band.
How many bands are placed?
Up to 3 bands are placed at a time.
Am I asleep?
The procedure can be performed with or without anaesthesia. I prefer to perform RBL at colonoscopy.
Is it painful?
As there are no nerve endings where the bands are placed there is not much pain. Patients have a feeling of fullness and the urge to open their bowels. This usually improves in 24 hrs but can last a few days.
What happens after the procedure?
Most patients have no symptoms after about 24hrs and can return to work then. After a few days there may be some bleeding when the haemorrhoid falls off. This is mild and lasts for a couple of days only. The bands fall off after about 3-4 days.
When can I return to normal activities?
24hrs after the procedure.
Are there any complications?
The bands can fall off early and the haemorrhoids can recur. Sometimes there is more pain than usual. This may be because the band is placed too low in a sensitive part of the anal canal. The band may require removal. There may be more bleeding than described above. Very occasionally this will need admission to hospital. Extremely rarely there can be infections associated with the bands requiring antibiotics and surgery.
Can the procedure be repeated?
The procedure can easily be repeated if for any reason there is recurrence.
What is the follow up?
Generally follow up is with your GP but Dr Pathma-Nathan will need to see you if bleeding recurs or persists.