The procedure is done together with colonoscopy under anesthetic. Colonoscopy is done to locate the hemorrhoids inside the rectum since they are high up your rectum and are not readily visible. A small instrument called a protoscope is used to insert a latex rubber band inside your rectum. The rubber band is then placed around the neck of the internal haemorrhoid to cut off its blood supply.

Pain here is bearable since the location of internal hemorrhoids is nowhere near pain-sensing nerves. This is also why an external hemorrhoid is not a candidate for rubber band ligation. It would be painful to do this to an external hemorrhoid because its location is near pain-sensing nerves.

You will also be asked by the surgeon whether the rubber bands feel too tight. If they are painful, a medicine may be injected into the banded hemorrhoid to numb them.

After manual strangulation of a hemorrhoid, it should shrink and fall off on its own within a few days. When the wound becomes dry, a scar will form in place. This scar is important for it will hold nearby veins and prevent them from bulging and forming into another hemorrhoid.

After 3 weeks, you’ll be re-assessed to determine how successful the procedure has been. Three weeks are allotted to give time for the manually strangulated hemorrhoid to shrink, fall off, bleed and the wound to dry off.

Bleeding may take about 10 days to stop. Because of this, it is not advisable to do the procedure if you are going to travel afterwards. Ample rest and proper cleaning is needed to avoid irritation and infection. Heavy lifting is avoided to avoid exacerbation and promote healing.

People respond differently to banding. Some are able to immediately resume to normal activities, except activities that involve lifting heavy objects, while others may take 2 to 3 days to recover.

The advantages of rubber band ligation over other treatment options are:

• no hospitalization is required
• minimal pain is felt
• shorter recovery period, therefore shorter time off from work.

It also has its disadvantages and limitations and they are:

• it may require more than one course of treatment to get rid of the hemorrhoid
• it is not applicable for treatment of external hemorrhoids
• success rate is only 60 to 80%

Rubber band ligation is the most common fixative procedure done to treat hemorrhoids. However, a variety of other surgical procedures may be an option. Each procedure has its own pros and cons to take into consideration. It is best to know all your options and study their details to be able to weigh and choose the best option for you.