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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

Rubber Band Ligation

An office treatment for internal hemorrhoids — a tiny rubber band cuts off the hemorrhoid's blood supply so it 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 Rubber Band Ligation?

Rubber Band Ligation (RBL) is a minimally invasive, non-surgical procedure used to treat symptomatic internal hemorrhoids. It is one of the most common and effective office-based treatments available. The procedure involves placing a small, specialized rubber band around the base of an internal hemorrhoid. This cuts off the blood supply to the hemorrhoid, causing it to shrink, wither, and eventually fall off within one to two weeks. The resulting scar tissue helps to hold the remaining hemorrhoidal tissue in place, preventing further prolapse.

Am I a candidate?

Who is a Good Candidate for RBL?

Rubber Band Ligation 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. Ideal candidates are those experiencing symptoms like painless bleeding or a feeling of fullness or prolapse. It is not suitable for external hemorrhoids or for patients with significant pain, as banding tissue below the dentate line can 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?

While Rubber Band Ligation is very safe, potential risks and complications can occur, though they are uncommon. These include:

  • Pain or Discomfort: A feeling of dull pressure or fullness in the rectum is common for 24 to 48 hours. Severe pain is rare and may indicate the band was placed too close to the pain-sensitive tissue of the anal canal.
  • Bleeding: Minor bleeding may occur when the hemorrhoid falls off, typically 7 to 14 days after the procedure. Significant bleeding is rare but requires immediate medical attention.
  • Thrombosis: A blood clot may form in an external hemorrhoid near the banded internal hemorrhoid, causing a painful lump.
  • Infection: Pelvic infection (sepsis) is a very rare but serious complication, characterized by fever, severe pain, and difficulty urinating. This requires urgent medical evaluation.
  • Band Slippage: The rubber band may occasionally slip off prematurely, which may require the procedure to be repeated.

How well it works

90%

trial

Success

n = 1,200 · 2022–2025

Resolution of bleeding and prolapse after single or repeat banding.

Sources

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