This information leaflet is to help you understand why you require banding of hemorrhoids.
Introduction
Hemorrhoids (piles) are enlarged blood vessels in the lining of the anus and lower rectum (back passage), these can become irritated resulting in bleeding, itching, discomfort and sometimes they can protrude from the back passage. Hemorrhoids are usually small and often the symptoms settle without any treatment, but sometimes treatment is required.
Banding is most effective for symptoms of bleeding from hemorrhoids that do not prolapse significantly. External / prolapsing hemorrhoids would usually require more invasive procedures if further treatment is desired.
Causes
Half the population in the UK will at some time develop one or more hemorrhoids, certain situations can increase the chance of hemorrhoids developing such as:
Constipation – Straining when opening bowels, passing large stools, resulting in increased pressure in and around the veins in the anus.
Pregnancy – Hemorrhoids are often common during pregnancy due to the effect of the pressure of the baby lying above the rectum and anus and hormonal changes during pregnancy on the veins.
Age – As we get older the tissue in the lining of the anus becomes less supportive.
Hereditary factors – There are some people who may inherit a weakness of the wall of the veins in the anal region.
Tips to Help
- Eat plenty of fibre, fruit, vegetables, whole meal bread and cereals
- Drink at least 10-12 cups of water per day (alcoholic drinks can be dehydrating)
- Avoid if you can, pain relief containing codeine
- Try not to delay going to the toilet when you get the urge, and avoid constipation and straining.
Banding Treatment
Your examination will be discussed with you by the surgeon and then your consent will be obtained. You will have to remove your clothes from the waist down and lie on the couch on your left side with your knees drawn up to your chest to enable the doctor to examine your back passage. A small tube will be passed into your back passage. Small elastic bands are then placed through the tube over the piles; they remain tight to reduce the blood supply to the pile.
The aim is that the piles will then shrivel and disappear which takes up to a couple of weeks. Often up to three hemorrhoids may be treated at one time using this method which is usually painless. The bands should fall off in about 5-10 days. The area heals over during the following 3-4 weeks.
Will this hurt?
The examination only takes a few minutes and can be uncomfortable; to help you can take some deep breaths and try to relax. This procedure does not require anaesthetic.
Benefits
In around 8 in 10 cases the hemorrhoids are removed successfully by this method; however, in 2 in 10 cases the hemorrhoids recur at some stage, in which case you may require further banding treatment. Hemorrhoids are less likely to recur after banding if you avoid constipation and straining.
Risks
A small amount of people may have complications following banding such as bleeding, urinary problems or infection at the site. If you see a large amount of fresh blood or you pass clots you must seek urgent medical attention.
The risk of bleeding means that we do not routinely perform banding of piles if you take anticoagulants such as Warfarin or novel oral anticoagulants (NOACs such as Apixaban or Rivaroxaban). These medications would need to be stopped prior to your examination. (this would be discussed prior to your examination appointment).
Recovery From Haemorrhoid Banding
You may feel pain or discomfort for up to 48 hours after your examination.
You may have a sensation of fullness in your back passage.
You may have the sensation of needing to move your bowels.
In addition, you may find difficulty in passing urine and in controlling wind or bowel movements for a few days. You may also bleed for up to 14 days after treatment and you may find at seven to 10 days when the hemorrhoid scar and band drops off that the bleeding becomes heavier, this is normal. The wound normally takes around two weeks to heal.
After the procedure you may need to take some regular pain relief such as paracetamol. Avoid any painkillers that may cause constipation such as codeine. Avoid any strenuous exercise on the day of your examination. You may resume normal activity the next day.
If you need a follow-up appointment this will be arranged at the time or follow-up will be with your GP.
