Rubber Band Ligation of Piles: Side Effects, Recovery Time

Rubber band ligation treats swollen blood vessels in the rectal area, also called internal piles. During the treatment, a doctor places a small rubber band around the haemorrhoidal base, cutting off its blood supply. It causes the piles to shrink and eventually fall off within a few days. 

Anatomy of the Anal Canal

The opening at the end of the digestive tract is called anus, through which faecal matter is expelled from the body. The anatomical structure of the anal canal can be elaborated as:

1. Anal Canal: It is part of the large intestine, about 2-3 centimetres in length, lined with mucous membrane. It contains the internal anal sphincter, a smooth muscle that is under involuntary control.

2. External Anal Sphincter: A ring-like muscle under voluntary control and helps regulate the passage of faeces from the rectum.

3. Anal Verge: This is the area immediately surrounding the opening of the anus. It may contain sensitive nerve endings and is susceptible to irritation and itching.

4. Anal Folds: The anal canal is lined with folds of mucous membranes called anal columns, which contain small blood vessels and glands.

5. Anal Glands: These are located in the lining of the anal canal that secrete mucus to lubricate the passage of faeces.

Haemorrhoids rubber band ligation is recommended for individuals with internal piles who did not benefit from conservative treatments like daily sitz baths. The other situations include:

1. Patients experiencing persistent symptoms such as bleeding, pain, itching, or discomfort.

2. Those with recurrent episodes of haemorrhoidal flare-ups.

3. Some individuals with prolapsed internal haemorrhoids. In this stage, the swollen blood vessels protrude from the anus.

Rubber band ligation is often used to address different grades of piles, ranging from mild to severe. The table is provided below for a better understanding.

According to Gastroenterol et al., 2022, the success rate of rubber band ligation ranges between 79% and 91.8%. The key reasons why this procedure is beneficial are:

1. Requires no incisions causing minimal discomfort and faster recovery.

2. It is a quick process, taking less than 10 minutes.

3. Carries a low risk of complications.

4. Patients can return home the same day, and most people may resume normal activities immediately. However, some patients would need 2 to 3 days of bed rest. 

Patients undergo a pre-operative consultation with their doctor. During this, the risks, benefits, and alternative options of the procedure are thoroughly explained. 

Before Surgery

Before rubber band ligation, patients are advised to avoid certain medications and to follow dietary recommendations to ease bowel movements. The process includes:

On the Day of Surgery

On the day of surgery, arriving at the healthcare facility on time is essential. Patients should wear comfortable clothing to ensure ease and comfort.

Rubber band ligation is a minimally invasive approach that takes less than 10 minutes to perform. However, the duration may vary if multiple piles are being treated. An overview of the process is provided below.

1. Anaesthesia: Topical anaesthesia will be administered to numb the area. In some cases, especially if piles are very painful or multiple, general may be required.

2. Insertion of Instrument: A specialised anoscope is gently inserted into the anal canal to visualise the haemorrhoids.

3. Placement of Rubber Bands: Using the anoscope for guidance, small rubber bands are placed at the base of the piles, cutting off their blood supply.

After rubber band ligation, it's essential to follow post-operative care instructions provided by the doctor. It promotes healing and minimises complications during the recovery period.

In Hospital Recovery

Following rubber band ligation, patients undergo a brief observation period in the hospital, usually lasting 1 to 2 hours. During this time, healthcare providers monitor vital signs and assess for immediate post-procedure complications. Once cleared, they are discharged home with instructions for managing any discomfort.

At-home Recovery

After discharge from the hospital following rubber band ligation, treated haemorrhoids gradually shrink and fall off within one to two weeks. Some expectations and recommendations during this period are:

1. Most individuals can resume regular activities immediately. However, some may require 2 to 3 days of rest to manage pain.

2. Over-the-counter pain relievers and sitz baths may help alleviate any discomfort.

3. Eating a high-fibre diet and staying hydrated can promote smooth bowel movements.

First Follow-up Appointment

The first follow-up appointment after haemorrhoids rubber band ligation typically occurs within one to two weeks post-procedure. During this visit, the healthcare provider assesses the healing progress and evaluates any remaining symptoms or concerns.

According to Bat et al. 2022, the complication rate after rubber band ligation is relatively low (4.2%), with most of the issues being minor. The most common risks involved are:

1. The patient may experience mild discomfort or pain for around two days. It is manageable with pain medications and sitz baths.

2. Minor bleeding after 10 to 14 days is common and resolves independently.

3. There is a small risk of infection at the site of the rubber bands.

When to consult a doctor?

Knowing when to consult a doctor after rubber band ligation is essential for promptly treating complications or concerns. The key indicators to consider are:

1. If bleeding does not clear within a day or two or becomes severe.

2. Signs of infection appear, such as increased pain, redness, swelling, or discharge from the anus.

3. Inability to pass urine after the procedure could indicate a urinary retention.

4. Allergic reactions like difficulty breathing or hives.

Haemorrhoids often cause discomfort, pain, itching, and bleeding. Delaying treatment like rubber band ligation can prolong these symptoms. It may also increase the risk of thrombosis (formation of blood clots within piles) or tissue necrosis (tissue death due to impaired blood flow).

Rubber Band Ligation Cost

The rubber band ligation cost can vary based on geographical location, insurance coverage, and any additional services required. The estimated expenses one can expect are:

Note: The figures mentioned above are just estimates. Please contact HexaHealth to get accurate information.

Factors that may affect the cost of rubber band ligation include:

1. Healthcare Provider: Costs may vary between different doctors based on their location, reputation, and the facilities they offer.

2. Severity of Condition: The number of piles treated may impact the total bill. Multiple sessions or additional treatments may be required for more extensive cases.

3. Complications: The overall price will increase if complications require additional medical intervention or treatment.

Rubber band ligation offers a minimally invasive and effective solution for treating internal haemorrhoids. With a relatively quick recovery time and low risk of complications, it is recommended for those seeking relief from piles.

At HexaHealth, we understand the importance of finding the proper treatment. Our platform connects patients with experienced doctors specialising in rubber band ligation for piles and other haemorrhoid treatments. Get in touch!

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