Hemorrhoid Banding

Hemorrhoid banding is a treatment option for stubborn hemorrhoids that do not go away with conventional home treatments. Also called rubber band ligation, hemorrhoid banding involves cutting off blood flow to the hemorrhoid using a rubber band. This minimally invasive, outpatient procedure is generally a successful procedure for people looking to get rid of their hemorrhoids but have been unsuccessful with non-surgical options.

Hemorrhoid banding has a success rate of between 70% and 97% percent, depending on the type and grade of hemorrhoid. The procedure helps remove the hemorrhoids and can be effective at preventing them from returning. Hemorrhoid banding is not the best solution for every person and every case of hemorrhoids, but many people find the procedure to be the best option when other treatments fail. As hemorrhoids become more common with age, people tend to seek more immediate treatment of the hemorrhoid to avoid discomfort. 

What are hemorrhoids?

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Hemorrhoids, also called piles, are a common issue that affect many people as they age. A hemorrhoid occurs when blood vessels inside the anus become swollen. The symptomatic hemorrhoids typically cause discomfort, tenderness, or itching. Many people will get them in their life, and you can often treat hemorrhoids with simple at-home treatments. 

Hemorrhoids can occur both internally and externally of the rectum. They develop over time as a result of strain or overuse that causes the veins to swell. Typical symptoms of hemorrhoids include an itchy anus, rectal bleeding, or tenderness around the anus. While hemorrhoids are generally not cause for concern and go away on their own, many people find them uncomfortable and want to treat them to go away and manage the pain. If you suspect you have hemorrhoids and no home treatments have proven effective, you can talk with your primary care physician about hemorrhoid banding. 

Why is hemorrhoid banding done?

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Banding is a treatment option for hemorrhoids because some hemorrhoids do not respond to home treatments, and they can cause considerable discomfort if left unaddressed. Typically, your doctor will recommend you try out home treatments first before moving forward with the hemorrhoid banding or an alternative treatment. However, if these options fail and the discomfort continues with your hemorrhoids, banding might be the best option for you. 

For those people with a family history of conditions like colon cancer, your doctor will take this into consideration before letting you have hemorrhoid banding. Your medical history may impact how often you need to get other checkups like colonoscopies.

Who should get hemorrhoid banding?

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Hemorrhoid banding is not an option for each case of hemorrhoids, so you should contact your doctor to discuss if hemorrhoid banding is a treatment option for you. Hemorrhoids typically dissipate on their own within a few days for smaller ones or a couple of months for more substantial hemorrhoids. Home treatments can help address any symptoms of hemorrhoids. However, some people will develop hemorrhoids that are resistant to treatment and may be a good candidate for hemorrhoid banding. 

Hemorrhoids that become painful, bleed persistently, or unbearably itchy may respond better to banding than to at-home options. The hemorrhoid banding procedure can only be used on internal hemorrhoids that form on the internal lining of the rectum and anus and is not an option for external hemorrhoids. When deciding if your case of hemorrhoids would be responsive to banding, be sure to consult with your primary care physician to discuss the procedure and the associated risks and recovery.

How to prepare for hemorrhoid banding?

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Your doctor may provide prepping instructions ahead of your hemorrhoid banding procedure. For example, depending on any prescription or over-the-counter medications you take, your doctor may tell you to temporarily stop taking those medications before the procedure. If you and your doctor decide on using anesthesia, you will need to follow fasting instructions from your doctor. 

Even though the banding procedure is an outpatient and noninvasive procedure, you will want to have someone join you for the procedure to be able to take you home and provide care for the days following. 

How is hemorrhoid banding done?

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Hemorrhoid banding is an outpatient procedure that typically takes less than an half hour and may be able to be completed at your doctor’s office or an outpatient center. The procedure does not require a hospital stay and often does not require you to be put under with anesthesia. Before the doctor applies the bands, they may apply a local topical anesthetic to your rectum to act as a numbing agent. Your doctor may also administer anesthesia, depending on your doctor’s guidance on the amount and pain level of your hemorrhoids. 

For the banding procedure, your doctor will insert a small lighted tube called an anoscope into the rectum followed by the band applicator tool, called a ligator. The ligator helps the doctor place the bands onto the base of each hemorrhoid to start restricting the blood flow. During the procedure, your doctor could also find blood clots, which they will attempt to remove as well. The whole procedure lasts a few minutes but may last longer if there are several hemorrhoids or other discoveries, like blood clots. 

What are the symptoms after a hemorrhoid banding procedure?

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The effects of the banding procedure take between 1 and 2 weeks. During this time frame, the hemorrhoid will dry up and then fall off on their own. There should be no pain when the hemorrhoid falls off, and you may not even notice when they do pass. Once they detach, they will typically pass with a bowel movement. 

You may experience some symptoms or general discomfort after the banding procedure, but each person will react to the procedure differently. Common side effects for the first few days after the procedure include:

  • Feeling full in your lower belly
  • Constipation
  • Abdominal pain 
  • Abdominal swelling
  • Gas and/or flatulence 

You may also experience some bleeding in the days following the procedure. This is a normal symptom, but if the bleeding does not stop after 2 or 3 days, you should contact your doctor. To help with these symptoms, your doctor may prescribe a laxative or stool softener to help with the constipation, bloating, and strain while your body recovers. 

What are the risks of hemorrhoid banding?

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Hemorrhoid banding is a common, safe, and effective procedure. Even though the procedure is common, it does come with a few health risks. Be sure to discuss the risks of the procedure with your doctor while making your hemorrhoid treatment plan so that you can make an educated decision. 

There is a risk of experiencing more severe side effects of a hemorrhoid banding procedure, including the following:

  • Recurring hemorrhoids 
  • Issues urinating 
  • Severe and persistent pain 
  • Signs of infection 
  • Fever and chills 
  • Excessive bleeding during bowel movements from the anus 

If you experience any of these symptoms after your procedure, call your doctor immediately as these could be signs of a more serious problem.

Are there alternatives to hemorrhoid banding?

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While hemorrhoid banding is an effective, nonsurgical treatment option for many who wish to remove their hemorrhoids, there are alternatives to this procedure that could be more effective for someone. Working with your primary care physician, you can discuss these other minimally invasive or surgical options. 

Electrocoagulation: This method involves using an electric current to heat the hemorrhoid, create scar tissue, and remove the hemorrhoid. Electrocoagulation typically does not prevent recurrence of a hemorrhoid, so they tend to recur. 

Sclerotherapy: For sclerotherapy, a doctor injects a chemical treatment into the hemorrhoid that cuts off the blood flow to the hemorrhoid. These treatments typically occur over a series of treatments and do not guarantee the hemorrhoids will not grow back. 

Surgery: Surgery is the most invasive technique to remove hemorrhoids and carries more risks than the other treatments described. Hemorrhoids likely will not recur after surgery.

What are at-home care options for hemorrhoid banding recovery and hemorrhoid prevention?

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The after care for a hemorrhoid banding procedure can help you heal more thoroughly and help prevent future hemorrhoids from forming. 


  • Rest and avoid strenuous activity to give your body enough sleep and prevent straining your muscles. 
  • Incorporate daily walks into your recovery to help increase blood flow and circulation to promote healing. 
  • Prepare a sitz bath of warm water and sit in the bath for 15 to 20 minutes up to 3 times a day to ease the pain and relax your digestive muscles. 
  • Use a cold compress to manage pain, but be sure to not place ice directly on your skin. 


  • Be in contact with your doctor about your prescription medications. If you had to take a break from using them for the banding procedure, your doctor will instruct you on when you can resume taking those. 
  • Take pain relievers as needed to help you with pain management from the procedure. 


  • You may want to temporarily adopt a low-fat diet to help ease your digestive system until you fully recover. 
  • Drink plenty of water. 
  • Incorporate foods high in fiber to help after your procedure but also to prevent future hemorrhoids.