Rubber band ligature

A small rubber band is put over a part of the enlarged haemorrhoidal knot to pinch off the inner protruding part of the knot. After the constricted tissue has died off, it is rejected together with the rubber band during defecation after about 2 days and excreted unnoticed. What remains is an internally flatter knot with a small scar. In the best case, this will also draw in an external anal prolapse.

This treatment is almost painless. The constricted haemorrhoidal knot can be felt as a foreign body or irritation of the bowel for about 2 days. Very rarely, additional pulling lower abdominal pain may occur. Very rarely, very sensitive people experience stronger pain sensations, who react well to ibuprofen tablets.

The treatment is carried out on an outpatient basis and without anaesthesia within 3 minutes. At the beginning, a slightly expanding proctoscope is inserted, through which the rubber band applicator is brought to the enlarged nodes. I use a suction applicator.

No special preparation, e.g. with enemas, is necessary. The normal toilet procedure before the treatment is sufficient. After the treatment, care should be taken to ensure smooth bowel movements. Weight training is prohibited for 3 days, all other physical activities are permitted.

Compared to sclerotherapy, a more permanent reduction of hemorrhoidal knots can be achieved with the rubber band binding. The recurrence of symptoms is only about 30% after 1 year for grade 2 hemorrhoids after completion of full treatment.

However, the treatment takes some time, as only one rubber band is applied at each session.

As haemorrhoids mostly occur as circular padding enlargement, about 3-4 sessions may be necessary.

During the first 3 weeks immediately after a rubber band is applied, no long-distance travel is allowed. This is because in the case of a strong after-bleeding occurring in 1:1000 cases, the bleeding site must be sutured within 1-2 hours. This risk exists in the first 3 weeks after the ligature.

For this reason, blood thinners (ASS, Aspirin, Falithrom, Marcumar, Plavix etc) must not be taken 7 days before treatment until 7 days after treatment.

By using latex-free rubber rings the risk of allergies is negligible.