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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Procedure

In office

Anoscopy with Rubber Band Ligation

The same office banding treatment for internal hemorrhoids, named for the small scope (anoscope) used to see and place the band — the hemorrhoid shrinks and falls away on its own, usually within a week to ten days.

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Setting
In office
Anesthesia
Usually none needed — the band is placed above the nerve line, where the lining feels pressure rather than sharp pain.
Back to work
Many people go back to regular activities right away; some take it slow for a day or two. Heavy lifting and straining are best avoided while things heal.
Pain relief
A dull ache or feeling of fullness for the first day or two is normal — over-the-counter pain relievers and warm sitz baths are usually all it takes.
Success rate
80-90%
Recurrence
10-20%

What it is

What is Anoscopy with Rubber Band Ligation?

Anoscopy with Rubber Band Ligation is a minimally invasive, office-based procedure to treat symptomatic internal hemorrhoids. The procedure involves the use of an anoscope, a small, rigid tube, to visualize the anal canal. Once the internal hemorrhoid is identified, a small, specialized rubber band is placed around its base using a ligator. This action cuts off the blood supply to the hemorrhoid, causing it to shrink, wither, and fall off within one to two weeks. The resultant scar tissue helps to anchor the remaining hemorrhoidal tissue, preventing further prolapse. Anoscopy is the standard method for performing this common and effective procedure.

Am I a candidate?

Who is a Good Candidate for the Procedure?

This procedure is an ideal treatment for patients with symptomatic Grade I, II, and select Grade III internal hemorrhoids that have not responded to lifestyle and dietary changes. Good candidates typically experience symptoms like painless bleeding during bowel movements or a sensation of fullness or tissue prolapse. The procedure is not appropriate for treating external hemorrhoids or for patients who have significant anal pain, as placing a band on the pain-sensitive anoderm would be extremely painful.

How it's done

  1. 1A small scope (an anoscope) is placed to see the inside of the anal canal — more awkward than painful, and over quickly.
  2. 2The internal hemorrhoid is gently drawn into a small banding instrument (a ligator) and a tiny rubber band is placed around its base.
  3. 3Because the band sits above the nerve line, most people feel pressure or fullness rather than sharp pain.
  4. 4Cut off from its blood supply, the banded tissue shrinks and falls away on its own, usually within a week to ten days, leaving a small scar that anchors the remaining tissue in place.
  5. 5You go home right away. Usually one or two hemorrhoids are banded per visit — if there are more, they're treated over separate visits.

What to expect

  1. First day or two

    A dull ache or sense of fullness in the rectum, or a feeling like you need to have a bowel movement. Over-the-counter pain relievers and warm sitz baths help; it settles over several days.

  2. About 7 to 10 days

    The banded tissue falls away — a small amount of bleeding when it does is normal and stops on its own. Bleeding that is more than spotting deserves a call.

  3. First weeks

    Fiber and fluids keep stools soft so you're not straining while the area heals — this also lowers the chance the hemorrhoids come back.

  4. Repeat visits

    It's common to need more than one session — banding treats one or two hemorrhoids at a time, and repeat treatment is part of the plan, not a failure.

  5. Call right away if

    Fever, trouble urinating, or pain that gets worse instead of better — these are rare, but they need prompt evaluation.

Risks & considerations

What are the Risks?

Anoscopy with Rubber Band Ligation is a very safe procedure, but potential risks can occur, though they are uncommon. These include:

  • Pain or Discomfort: A sensation of dull pressure or fullness in the rectum is common for 24 to 48 hours. Severe pain is rare and may indicate that the band was placed too low, near the sensitive anal canal skin.
  • Bleeding: Minor spotting may occur when the hemorrhoid falls off, usually 7 to 14 days after the procedure. Significant bleeding is rare but requires immediate medical attention.
  • Thrombosis: A painful blood clot (thrombosis) can form in an external hemorrhoid adjacent to the banded internal hemorrhoid.
  • Infection: A serious pelvic infection (sepsis) is a very rare but dangerous complication. Symptoms include fever, severe pain, and difficulty urinating, and require urgent medical care.
  • Band Slippage: Occasionally, the band may slip off prematurely, which might necessitate repeating the procedure.

Sources

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