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The rubber band ligation is a second-line treatment for mild and moderate piles. No anaesthetic is required and you are able to go home almost immediately. This is a procedure in which elastic bands are applied onto an internal haemorrhoid at least 1 cm above the dentate line to cut off its blood supply. Within 5–7 days, the withered haemorrhoid falls off. Cure rate has been found to be about 87%. Recently it was shown that the series of rubber band ligation is equally effective than the methods using advanced technology (like Laser, radiofrequency, etc.), but costs the friction of it.*
*Ref: S. Brown, Haemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree haemorrhoids (HubBLe): a multicentre, open-label, randomised controlled trial, Lancet. 2016 Jul 23; 388(10042): 356–364.
The sclerotherapy is a procedure when a special liquid is injected into your piles to make them shrink. No anaesthetic is required and you are able to go home straight after the procedure.
Advantages of the banding procedure
No anaesthesia, no sedation
Minimal time off work
May require more than one course of treatment
Does not deal with external skin tags and loose skin of haemorrhoids
There is a small risk of complications such as aggravation of other haemorrhoids, bleeding, pain or infection.
The pain is difficult to predict and is usually not severe. There is a bearing down sensation sometimes and painkillers taken after the procedure is helpful.
what to EXPECT after the BANDING treatment
Immediately after the procedure there may be some mild discomfort in the back passage and you may also experience some lower abdominal discomfort or pain. This usually lasts for less than 24 hours and is easily treatable - if required - by simple analgesics. Our recommendation is to start with 1000mg of paracetamol 4 times per day. If that is not enough, then please take 200mg of ibuprofen 3 times per day in addition to this. These are over-the-counter medications, you do not need prescriptions to obtain them. Over the next few days the piles often become irritated and a little swollen. You may feel a lump in the anus and some discomfort, especially when going to the toilet. If this bothers you, you may take the painkillers mentioned above and you can use some (over-the-counter) haemorrhoid cream or suppository. After the pile shrivels it falls off after a week or so and there is often a small amount of bleeding. Don't worry, this is normal.
HOW TO PREVENT THE HAEMORRHOIDS RECURRING?
A good bowel habit is the key to preventing haemorrhoids from forming. The main recommendations are:
Prevent the motions from being too hard. You can help to keep the motions soft by eating a diet high in fibre, drinking plenty of fluid with meals and - if necessary - taking mild laxatives such as Fybogel from the chemist.
Try not to strain when passing motions. Go to the toilet when you feel the urge. Different people have different numbers of bowel movements in a day. Don’t try and strain to have a bowel movement unless you feel the urge to and don’t try too hard to ‘push out every little bit’!
Don’t spend too long on the toilet. When sitting down, the weight of the body pushes down into the pelvis and will cause the lining of the back passage to swell. Aim to spend around 2-3 minutes sitting down when having a bowel movement.