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Hemorrhoidal Banding

Hemorrhoids are swollen veins that occur inside and outside of the rectum. They can cause symptoms such as rectal pain, burning, itching, and bleeding. Hemorrhoids that cause these bothersome symptoms are usually initially treated with medication, along with stool softeners, fiber, and Sitz baths. Medications can be over the counter or prescription. They can be creams, ointments, wipes, or suppositories. The creams and suppositories usually contain hydrocortisone, a steroid. When these medications fail to control the symptoms of hemorrhoids, the next step in their management is either an endoscopic procedure or surgery. Internal hemorrhoids may be able to be treated with a quick procedure, performed during a colonoscopy or sigmoidoscopy.

The procedures for hemorrhoids are usually less invasive and less painful than surgery. There are various types of procedures that can be performed for hemorrhoids. These include banding, cauterization, sclerosant injection, and laser ablation. Although some studies favor one technique over the others, they are in general all acceptable means of treating hemorrhoids. This office favors hemorrhoidal banding.

During your procedure, the doctor will evaluate your hemorrhoids and determine if they are suitable for banding (based on size, location, etc). If they are suitable, the doctor will suction up the hemorrhoid into a special cap on the scope, and then release a small rubber band onto the base of the hemorrhoid. This may be performed for up to three hemorrhoids at a time (any more could result in pain and difficulty having a bowel movement). The entire banding procedure takes only a few minutes. The bands will usually fall off in about 5-7 days (sometimes earlier and sometimes later). You may have a pressure feeling in your rectum, or feel the need to urinate. Other possible symptoms include bleeding (usually stops on its own) and pain. Rarely, the bands cause pain that requires pain medication, however this usually goes away in 1-2 days. Your doctor may choose to prescribe pain medication after the procedure. Other rare complications include fever, nausea, vomiting, and infection.

Some patients may require more than one banding procedure, especially if they have multiple hemorrhoids. The amount of time that patients are symptom-free depends on the number of hemorrhoids and whether they adhere to the doctor’s recommendations afterward (weight loss, treatment of constipation, avoidance of straining). Some patients never have problems again, and some will have a return of their symptoms in a few years.

You will receive instructions for care of your hemorrhoids after the procedure. If you have any other questions, please speak with your doctor.

Post-Hemorrhoidal Banding Instructions

You have just undergone hemorrhoidal banding, an effective and safe method of dealing with bothersome internal hemorrhoids. You may experience some rectal pressure and even mild to moderate discomfort, but it is unusual to have significant pain after the procedure. It is important that you now adhere to the below instructions to make sure the banding is effective and to avoid possible side effects.
For the next 1 week, you should do the following:
1) Take Miralax 17g in 8oz of water once daily
2) Take a stool softener (ie, Colace 100 mg) twice daily
3) Soak your rectal area in a Sitz bath for 15 minutes three times a day. A Sitz bath is simply a warm bath with or without Epsom salts.
4) Drink plenty of water.
5) Avoid straining or bearing down during bowel movements. Avoid aggressive wiping after bowel movements.
6) Avoid heavy lifting or straining for 2 weeks.
To prevent the hemorrhoids from coming back in the future, you should use a fiber supplement (Metamucil, Citrucel, Benefiber, Fibersure, etc) every day, drink plenty of water, and exercise at least 4 times per week.
You should follow up with us in the office in the next 4 weeks. Call our office at 740-356-6828 if you experience any of the following: fevers, chills, nausea, vomiting, bleeding that doesn’t stop after one day, or pain that is not going away.

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