Rubber Band Ligation of Piles: Side Effects, Recovery Time

 Rubber Band Ligation (Hemorrhoidal Artery Ligation)

Treatment Duration

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15 Minutes

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30 Minutes

Treatment Cost

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23,000

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60,000

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 Rubber Band Ligation (Hemorrhoidal Artery Ligation)

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Are you looking for a quick and minimally invasive procedure to remove piles? If so, rubber band ligation might be the solution you've been searching for. This outpatient method offers an effective way to treat internal haemorrhoids, providing relief from symptoms such as bleeding and pain.

Curious to learn more? This blog will provide information on rubber band ligation for piles, covering its benefits, risks, and so on!

Procedure Name

Rubber Band Ligation 

Alternative Name

Haemorrhoid banding

Conditions Treated

Internal haemorrhoids

Benefits of Procedure

Minimally invasive, low risk of complications

Treated By

Gastroenterologists, proctologists

What is rubber band ligation?

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.

Who needs a rubber band ligation?

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.

Grades of Piles Treated with Rubber Band Ligation

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.

Grade of Piles

Description

1

Internal haemorrhoids that bleed but do not protrude from the anus

2

Piles that prolapse during bowel movements but retract spontaneously

3

Prolapsed haemorrhoids that require manual reduction after protrusion

4

Piles that remain prolapsed and cannot be manually reduced

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Benefits of Rubber Band Ligation

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. 

Before and on the Day of Rubber Band Ligation

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:

Parameters 

Pre-Requisites

Pre-op Assessment

Digital rectal exam (DRE), physical examination

Risk Evaluation

  1. Potential allergies

  2. Procedural risks vs benefits

Anaesthesia Selection

Topical or local

Fasting

Medication restrictions for 4-5 days 

  1. Blood thinners

Avoid eating or drinking for 12 hours 5


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.

Parameters

Pre-requisites

Consent

Mandatory

Physical Evaluation

Vital signs monitoring, including blood pressure, body temperature, and pulse rate

Anaesthesia Administration

Administered dosage is based on physical evaluation

Rubber Band Ligation Procedure

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 Surgery and Recovery

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.

Risks and Complications of Rubber Band Ligation

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.

Risks of Delaying Rubber Band Ligation

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:

Treatment

Estimated Cost Range

Rubber Band Ligation 

₹ 23,000 to ₹ 60,000

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.

Takeaway

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!

Suggested Reads

Piles Laser Treatment Stapler Surgery for Piles
Non Surgical Treatment for Piles How to Cure First Stage of Piles

Frequently Asked Questions (FAQ)

Rubber band ligation (RBL) of haemorrhoids is a minimally invasive technique where small rubber bands are placed at the base of internal piles. It cuts off their blood supply, causing them to shrink and eventually fall off.

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Rubber band ligation is performed by inserting an anoscope to visualise the internal haemorrhoids. The small rubber bands are placed at the base to cut off the blood supply, leading to their gradual shrinkage and elimination.

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Rubber band ligation for haemorrhoids offers several advantages as a minimally invasive treatment option. The key benefits are:

  1. No incisions or general anaesthesia required

  2. Allows for a rapid return to normal activities

  3. Performed in a clinic setting with minimal downtime

  4. Low risk of complications

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Rubber band ligation may cause mild discomfort or pain during and after the procedure. It can usually be managed with over-the-counter pain relievers and sitz baths.

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Rubber Band Ligation, while generally safe, carries potential risks and complications. The key points to consider are:

  1. Post-procedure pain or discomfort

  2. Mild bleeding is common; severe bleeding is rare but possible

  3. Risk of infection at the site of rubber band placement

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Recovery time after rubber band ligation is mostly short, with most individuals able to resume normal activities within a day or two. Complete healing usually occurs within one to two weeks, during which discomfort and bleeding gradually subside.

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Rubber bands used in rubber band ligation fall off within 1 to 2 weeks after the procedure. This causes the treated haemorrhoids to shrink and eventually pass unnoticed during bowel movements.

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Rubber band ligation should not be attempted at home as it requires specialised equipment and expertise to ensure safety. It is a medical procedure performed by trained healthcare professionals in a clinical setting.

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Rubber band ligation is highly effective for treating haemorrhoids, providing relief in approximately 8 out of 10 individuals. It offers a high success rate in reducing symptoms such as bleeding and pain.

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After rubber band ligation, certain dietary modifications may help promote smoother bowel movements. These include:

  1. Stay hydrated by drinking plenty of water

  2. Increase fibre intake through fruits, vegetables, and whole grains

  3. Avoid spicy foods and alcohol until your next visit to the doctor

  4. Limit caffeine consumption

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While most individuals can immediately resume regular activities following rubber band ligation, some may need 2 to 3 days of rest. This will help manage any discomfort or pain associated with the procedure.

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Up to 3 sessions of rubber band ligation may be needed, spaced two weeks apart. This is because each haemorrhoidal vein is addressed individually during each session to minimise discomfort and complications.

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There are some effective alternatives to rubber band ligation for haemorrhoids available. These include:

  1. Haemorrhoidectomy: Surgical removal of piles.

  2. Sclerotherapy: Injection of a chemical solution into piles to shrink them.

  3. Coagulation therapy: Use of heat or laser to shrink haemorrhoids.

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During follow-up appointments after rubber band ligation, the doctor assesses the healing progress and evaluates any remaining symptoms. They may recommend further treatment or adjustments to the recovery plan.

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Rubber band ligation for haemorrhoids is covered by insurance plans, but coverage may vary depending on the insurance provider and policy terms. It's advisable to check with HexaHealth to understand specific details and any out-of-pocket expenses.

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The estimated rubber band ligation cost starts from ₹ 23,000 and can go up to ₹ 60,000. The average price is ₹ 41,500. Contact HexaHealth for up-to-date information.

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Rubber band ligation has shown high success rates, with repeated banding sessions showing efficacy of up to 94%. This makes it a commonly recommended and effective outpatient procedure for symptom relief.

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While rubber band ligation is effective, there's a possibility of haemorrhoids recurring over time. This can especially happen if underlying factors like constipation aren't addressed.

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Haemorrhoid banding is generally considered safe, with minor complications reported in only 4.7% of cases. This makes it a low-risk outpatient procedure for treating internal piles.

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. Albuquerque A. Rubber band ligation of hemorrhoids: A guide for complications. World Journal of Gastrointestinal Surgery. 2016;8(9):614.link
  2. Cleveland Clinic. The Anus [Internet]. Cleveland Clinic. 2023. link
  3. Hemorrhoid Banding: Preparation, Procedure, Recovery, and Risks [Internet]. Healthline. 2018. link
  4. Stavrou G, Tzikos G, Malliou P, Panidis S, Kotzampassi K. Rubber band ligation of hemorrhoids: is the procedure effective for the immunocompromised, hemophiliacs and pregnant women? Annals of Gastroenterology [Internet]. 2022;35(5):509–13.link
  5. Banding/Ligation of Hemorrhoids: CRH O’Regan System [Internet]. National Jewish Health. [cited 2024 Apr 26].link
  6. Singh R, Arya R, Minhas S, Dutt A. A comparative study of Barron′s rubber band ligation with Kshar Sutra ligation in hemorrhoids. International Journal of Ayurveda Research. 2010;1(2):73.link
  7. Rubber Band Ligation for Hemorrhoids: What to Expect at Home [Internet]. myhealth.alberta.ca. [cited 2024 Apr 26].link
  8. Kumar M, Roy V, Prasad S, Jaiswal P, Arun N, Gopal K. Outcomes of Rubber Band Ligation in Haemorrhoids Among Outdoor Patients. Cureus. 2022 Sep 29;link
  9. Thrombosed Hemorrhoid: What Is It, Causes, Diagnosis, Treatment, and More | Osmosis [Internet]. www.osmosis.org.link
  10. Rubber Band Ligation (Hemorrhoidal Artery Ligation) Cost in India - Calculate Estimated Cost [Internet]. www.hexahealth.com. [cited 2024 Apr 26].link

Reviewer

Dr. Saurabh Kumar Goyal

Dr. Saurabh Kumar Goyal

MBBS, MS General Surgery

16 Years Experience

Dr Saurabh Kumar Goyal is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic. He has 16 years of experience in general and laparoscopic surgery and worked as an expert Surgeon in ...View More

Author

Sparshi Srivastava

Sparshi Srivastava

B.Tech Biotechnology (Bansal Institute of Engineering and Technology, Lucknow)

2 Years Experience

An ardent reader, graduated in B.Tech Biotechnology. She was previously associated with medical sciences secondary research and writing. With a keen interest and curiosity-driven approach, she has been able to cont...View More

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