Hemorrhoid Banding (in-office)

Hemorrhoids are a collection of blood in the venous system (engorged veins) that occurs in the anal region either internally or externally. There are so many risk factors to the development of hemorrhoids such as chronic constipation, anal intercourse especially for men who have sex with men and obesity.
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Hemorrhoid Banding (in-office)

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Hemorrhoids are a collection of blood in the venous system (engorged veins) that occurs in
the anal region either internally or externally.
There are so many risk factors to the development of hemorrhoids such as chronic
constipation, anal intercourse especially for men who have sex with men and obesity.

There are many treatment options when dealing with the hemorrhoids such as hemorrhoidectomy, hemorrhoid stapling and hemorrhoid banding. Each has an advantage over the other approaches. The main advantages of the hemorrhoid banding are that it is a fairly easy approach that can be done in the outpatient setting and is associated with very few recurrences compared to other modalities of treatment. In addition to this, it is very costeffective. The disadvantage of this approach is that the doctor can only put as many bands in one session; therefore the patient has to make frequent visits to the hospital especially in the case of multiple internal hemorrhoids.
There are many treatment options when dealing with the hemorrhoids such as hemorrhoidectomy, hemorrhoid stapling and hemorrhoid banding. Each has an advantage over the other approaches. The main advantages of the hemorrhoid banding are that it is a fairly easy approach that can be done in the outpatient setting and is associated with very few recurrences compared to other modalities of treatment. In addition to this, it is very costeffective. The disadvantage of this approach is that the doctor can only put as many bands in one session; therefore the patient has to make frequent visits to the hospital especially in the case of multiple internal hemorrhoids.
The underlying principle for this form of treatment is the strangulation of the blood supply of the hemorrhoids as they are highly vascularized structures, therefore, they cut off because of the selective ischemia caused by these bands.

Indications

For symptomatic internal hemorrhoids.

How is the procedure done

Hemorrhoids are highly vascularized structures. This treatment approach (hemorrhoid banding) involves putting small round bands till the base of the hemorrhoid thus constricting its blood supply. In a about a week or so, the hemorrhoid will shrivel and come out because of the limited blood supply.
The banding is usually done with an anoscope, which is inserted through the anus and it easily fixes the band at the base of the hemorrhoid.

If the patient has multiple hemorrhoids, this procedure is repeated until all hemorrhoids are
taken care off. The time interval between the removal of one hemorrhoid to the other in the
case of multiple hemorrhoids is about 1-2 weeks.

Pain control of the patient should be of greatly considered. The patient should go home with
strong painkillers.

Risks

Because of the constricted blood supply in a region, the patient may be prone to blood
clots formation.

The banding of the hemorrhoids by itself can be very painful, the prescription of painkillers
must be considered. 

How you prepare for the surgery

This is a fairly straight forward surgical procedure with minor complications.

A proper physical examination and lab work should be done to rule out other fatal conditions
such as rectal cancer or colon cancer that might present in a similar way to the hemorrhoids.

The patient must communicate with the doctor about the current medications that they are taking especially the anticoagulants as this procedure could cause a lot of bleeding. In addition to this, any family history of a bleeding disorder should be disclosed to the doctor before the procedure.
Rarely, but if general anesthesia for this procedure is required, especially if you have multiple hemorrhoids and several are being banded at a go, as a general rule, you should fast for approximately 8 -12 hours to prevent the complications of the anesthetic agent.
Plan for any assistance you might need in advance, this could include in the workplace or at home or help when leaving the hospital for home. Avoid straining at all cost post-surgery.

Recovery after surgery

It is an in-office procedure, therefore the patient can comfortably go home immediately after the treatment. This surgical approach follows an almost similar pattern to that of the umbilical stump after birth by the way the band falls off and how it is used. The banding should fall off on its own in about a week and the next week the patient will be fully healed
The patient should be advised on a diet that is not hard on the healing post-hemorrhoid scar. Laxatives are a good aid for the bowel movements especially to alleviate any constipation that might occur

It is however normal if the patient bleeds a little per rectum after a few days of the banding. But
if it persists for more than 2-days the patient should immediately go back to the doctor.

Avoid heavy lifting or any other strenuous exercise until the patient is fully healed, sitz baths are recommended at least once daily because they keep the anal area clean.

Outcomes after surgery

This approach offers very successful hemorrhoid treatment with few recurrences.