Rubber-band ligation

Rubber-band ligation is a medical procedure used to treat hemorrhoids, which are swollen veins located in the lower part of the rectum and the anus. This procedure is considered a minimally invasive treatment option and is commonly performed in a doctor's office or an outpatient setting. Rubber-band ligation involves the application of one or more tight, elastic bands around the base of the hemorrhoid, cutting off its blood supply. Within a few days, the treated hemorrhoid shrinks and falls off, leaving a small wound that heals on its own.

Procedure

The procedure is typically performed without the need for anesthesia, although some patients may require a local anesthetic. The doctor uses a device called a ligator, which can be either a manual tool or a device attached to the end of a sigmoidoscope or colonoscope, to grasp the hemorrhoid and place the rubber bands around its base. The process usually takes only a few minutes and is relatively painless, although some patients may experience discomfort or mild pain afterwards.

Indications

Rubber-band ligation is most effective for treating internal hemorrhoids that are classified as Grade I, II, or III. Grade I hemorrhoids are small inflammations that have not prolapsed outside the anal canal. Grade II hemorrhoids prolapse out of the anal canal during bowel movements but retract spontaneously, while Grade III hemorrhoids prolapse and require manual reinsertion. This procedure is not recommended for Grade IV hemorrhoids, which are large and permanently prolapsed, or for patients with certain medical conditions that may increase the risk of complications.

Advantages and Disadvantages

One of the main advantages of rubber-band ligation is its effectiveness and safety, with a low risk of complications. It also allows patients to return to their normal activities shortly after the procedure. However, there is a possibility of recurrence, and some patients may require additional treatments. Disadvantages include temporary discomfort, pain, and, in rare cases, more serious complications such as significant bleeding or infection.

Complications

While rubber-band ligation is generally safe, complications can occur. These may include pain, bleeding, thrombosed hemorrhoids (where a blood clot forms inside the hemorrhoid), or, very rarely, pelvic sepsis, a serious infection that requires immediate medical attention.

Aftercare

Patients are advised to follow a high-fiber diet, drink plenty of fluids, and avoid straining during bowel movements to ease recovery and reduce the risk of recurrence. Over-the-counter pain relievers can help manage discomfort. Most patients can resume normal activities the same day or the day after the procedure, although heavy lifting and strenuous exercise should be avoided for a short period.

Conclusion

Rubber-band ligation is a widely used and effective treatment for internal hemorrhoids, offering a safe and minimally invasive option for patients. While it has a high success rate, individuals considering this procedure should discuss the potential risks and benefits with their healthcare provider.