Haemorrhoid Banding 

Haemorrhoids, often called piles, are areas in the anal canal where tissue containing blood vessels have become stretched or swollen.

Haemorrhoids can be internal i.e. inside the anus, or external at the anal opening. Increased pressure on the blood vessels of the lower rectum cause them to swell or stretch. The increased pressure can come from constipation, straining as you move your bowels, obesity, diarrhoea, pregnancy, heavy lifting or even prolonged coughing or sneezing.Often there is no obvious cause for the development of haemorrhoids.

The most common symptoms are bleeding, protrusion, discomfort and itching, and sometimes a mucous discharge.

Preparation

You will be asked to come in at least one hour before your procedure. This is for admission purposes which may include:

  • Medical Assessment
  • Administration of enemas

 

You should mention:
• An allergy or bad reaction to medicines or anaesthetics
• Taking medication to thin your blood including Warfarin, Dabigatran, Rivaroxaban, Aspirin or antiplatelet medication:
 e.g. Clopidogrel or Ticagrelor. Your doctor may ask you to stop taking these medications prior to your procedure or you may be
 given an alternative dose.
• Prolonged bleeding/clotting disorders or excessive bruising
 

If you have any queries please contact our Endoscopy Clinic or after hours the Duty Manager on 09 623 5700


Because sedation is generally used during the procedure it is important that you do not drive or operate machinery for 12 hours afterwards. Please arrange for someone to drive you home at the end of the examination.

Procedure

There are different degrees of treatment. Conservative treatment usually involves increasing your fibre intake to soften the stool. There are ointments and suppositories available to reduce swelling and irritation. Salt baths can be helpful. In some cases where bleeding and pain persists other treatments may be recommended. These include injection, band ligation and surgery.

Injection Sclerotherapy

 A small amount of irritant fluid is injected into the haemorrhoid causing it to shrink away. This is an effective treatment for smaller internal haemorrhoids that bleed. This technique is not particularly painful and is usually undertaken once or twice. It is associated with minor bleeding which usually settles over a couple of days. Pain relief is usually with paracetamol. A warm bath is also helpful and it is important to keep the bowels soft and regular. You can resume normal activity after the procedure.

Rubber Band Ligation 

This treatment is more effective for the larger internal haemorrhoids which often bleed and prolapse through the anus. 

Haemorrhoidal banding works by using a constricting rubber band to stop the flow of blood into the haemorrhoids, thus causing them to shrivel and fall off along with the band. This usually happens within 2- 5 days. The wound that is left will then slowly heal.

 Haemorrhoidal banding is performed with a suction ligator. Before the procedure you are usually given an enema to clear the rectum of any faecal matter. You will be asked to lie on your left side with your knees drawn up and buttocks projecting over the trolley bed. A lubricated proctoscope is inserted into the anal canal. Gentle suction is used whilst the latex free bands are placed above the haemorrhoids.

Haemorrhoidal bandings will be performed with intravenous sedation and pain relief to keep you comfortable throughout. A small needle will be placed, usually into the back of your hand, through which the sedative injection is given. 

This is NOT a general anaesthetic and you will NOT be completely asleep during the procedure, but you will be relaxed and the medication may make you forget what has happened.

Payment Details

  • We advise you to apply to your insurance company for prior approval before your admission. (except Southern Cross members )
  • Bring your prior approval number or letter to your appointment
  • Your account will be given to you on completion of your examination to forward to your insurance company for settlement
  • If you do not wish to apply for prior approval or do not have medical insurance we will calculate an estimated total cost of your procedure, which will be charged on admission
  • On completion of your stay your account will be processed and the amount adjusted accordingly. The total amount charged varies from patient to patient and any extra charges will be expected to be settled on discharge

Risks

Some of the complications that can occur in the first fortnight are:

  • It is common to have pain after the procedure. It is very variable between patients and will usually settle in 48 hours. Very occasionally it can go for 4-5 days. Mild pain killers such as paracetamol and anti-inflammatories can help.
  • Some bleeding is normal at the first bowel movement after the procedure and also in the first 1-2 weeks. Severe bleeding occurs in less than 1% and requires hospitalisation.
  •  It is common to get some spasm in the pelvic muscles which can lead to constipation. Extra kiwifruit or some similar fruit may help. A mild laxative may be prescribed.
  • In about 5% of patients, a very painful blood clot develops in a condition called thrombosed external haemorrhoids. It will usually settle over 7-10 days with hot baths, local ointment and pain killers.
  • Fissures (small ulcers in the anal canal) can develop in about I% of the patients as a result of the sloughing of the haemorrhoid. This will result in pain with your bowel motion. If this persists talk to you specialist. There are special creams to help healing in this situation.
  • Infection and pelvic sepsis are extremely rare after banding, but if you become generally unwell, develop a high temperature or have problems urinating, seek medical help.

MAKE SURE YOU HAVE A FOLLOW UP VISIT WITH THE SPECIALIST AT 3-4 WEEKS