Is the Banding Hemorrhoid Procedure Really Helpful?

History of Banding Hemorrhoids 

One can trace the origin of banding Hemorrhoid, also known as the rubber band ligation technique, right back to 460 BC. In his writings, Hippocrates mentioned a surgical procedure where a thread was tied around the hemorrhoids, which caused the protrusions to shrink and finally shrivel. 

During the nineteenth century, this technique was among the more popularly used ones to cure hemorrhoids. However, due to the pain involved, it fell out of practice quite fast. 

In the mid twentieth century, Blaisdell came up with the suggestion that only the hemorrhoidal tissue should be ligated. This would be cause much less pain. The modern technique practiced today is credited to Barron, who applied the bands with precision using a special instrument. This technique and the instrument were named after him as an honorary gesture. Nowadays, we frequently hears of the Barron’s Ligature method and the Barron ligator in the treatment of hemorrhoids. 

How It Works 

In the rubber band ligation technique, a constricting band it tied around the hemorrhoid, causing the flow of blood to that region to stop. As a result, the hemorrhoids shrivel and subsequently fall off within 7 to 10 days.

This is an extremely effective technique for the treatment of second-degree hemorrhoids, but patients with third-degree piles should not consider it. For that matter, even second degree cases that show bulky protrusions are advised against using this procedure. If you’ve already undergone sclerotherapy treatment for your hemorrhoids, you’ll find the rubber band ligation technique not responding well. 

The Equipment Used 

Originally, the Barron ligator consisted of two concentric barrels that were connected to each other by a long shaft. With the help of a handle the outer barrel could be moved over the inner barrel. This action caused the rubber band (of about 1mm diameter and 2.5 mm thickness) to be pushed forward onto the base of the hemorrhoids. 

This design obviously underwent many changes and has been improved greatly in the recent years. The McGiveny ligator, for instance, has an additional short cylinder, located at the end of the shaft, into which the hemorrhoid is inserted either manually or with the help of vacuum. This additional feature allows the band to be fixed with more precision. 

Procedure of the Rubber Band Ligation Technique

• Pre-operative Medications

  Before the procedure is carried out, the patient is told not to consume any medication that might prompt excessive bleeding. These medicines include aspirin and coumadin. If the patient has some form of immune system deficiency, uses implanted prosthetic devices, such as heart valves or artificial joints, or is on steroid medications, doctors advise pre-operative antibiotics. Pain killers can also be prescribed for patients who are highly anxious. Enemas are also usually given so that any stool in the rectum can be cleared out. 

  
  

• Position

  The most common position assumed for the procedure is the left lateral position. The patient lies down on his left side on the surgical table, drawing up his knees so that his buttocks are projected over the edge of the table. 




• Application of Band 

  Before being inserted into the anal canal, the proctoscope is warmed and lubricated. A forcep is used to hold the hemorrhoid so that it can be pulled through the barrel of the instrument. The cylinder is pushed upward and when it reaches the end of the hemorrhoidal tissue, the handle is squeezed and the rubber band is applied at the base of the piles. 




In some cases, two rubber bands are applied onto each hemorrhoid, so that the blood supply is thoroughly cut off. This is also a precaution to ensure that in case one band breaks, the other one is still in place. 




Post banding hemorrhoid pain can be reduced with the help of local anesthesia. If there is a lot of sharp pain, it usually indicates towards a procedure that hasn’t been accomplished well. Either the band has been applied too low in the canal region that is sensitive, or the doctor has accidentally banded too much sensitive skin and tissue. In such a situation, the band needs to be removed immediately and then applied all over again. 




According to studies that have been carried out, rubber band ligation is as effective as other methods that are used to treat hemorrhoids of similar grade. 60 to 80% of patients who have tried this technique have declared themselves to be completely satisfied.

Controversies 

There are two main controversies that have associated themselves with the rubber band ligation technique.

The first controversy is related to the number of hemorrhoids that can be treated at one time. According to Barron, only one hemorrhoid was to be treated at a time, or it could cause the anal canal to become narrow, resulting in constipation. If more than one hemorrhoid has to be treated, it’s advisable that they be targeted at intervals of 3 weeks each. However, there are a few doctors who believe that multiple hemorrhoids can be targeted successfully without any complication or side effects. 

The other controversy is regarding the injection of local anesthetic into the banded location. There are many who believe that this hardly decreases the pain after the completion of the procedure. In fact, they believe that if local anesthetic was to be used, they’d be unable to identify the pain associated bands that have been applied improperly. 

Besides, too much anesthetic can lead to other health complications, like arrhythmia (a condition where the rhythm of the heart beat gets altered) or heart block. 

Complications 

There might be a few complications related to this procedure. Some of them are as follows: 

• Pain 

  As mentioned before, when you band hemorrhoids incorrectly, there is a sharp pain. In this case, the band should be removed and the entire procedure repeated. In normal cases, there will be a mild pain which should disappear within a couple of hours. Injecting a local pain killer into the site can help relieve mild pain.




• Bleeding 

  Patients can expect some bleeding when they pass stool for the first time after the procedure. However, it is extremely rare for patients to bleed so excessively that they require blood transfusion or hospitalization. After the hemorrhoid falls of, there will be some bleeding which will stop eventually. If the flow of hemorrhoids blood doesn’t stop, you may need to apply adrenaline locally or have the wound stitched. 




• Band slippage 

  The band may slip off, in case there is very little pile mass that needs to be banded. To prevent slippage, some doctors use two bands on each hemorrhoid. If the band does slip, all that needs to be done is to re-apply it. 




• Infection and Pelvic Sepsis 

  Sepsis is an extremely rare complication which can be serious and threaten your life. Sepsis is a condition where the infection from the banded site gets into the bloodstream, causing infection that can spread throughout the body. Symptoms of this infection are pain, inability to urinate, and fever. If these symptoms are noticed, you should immediately consult a doctor. 




• Blood clot 

  5 out of 100 patients may experience a condition known as thrombosed hemorrhoids, in which they develop a very painful blood clot. Surgery may be required to get rid of this problem. 




• Anal fissure 

  Sloughing of the hemorrhoid can cause fissures to develop in a few patients. Most cases of anal fissure can be cured with pain killers. In some cases, it may require surgical intervention.

Remember,

• Hemorrhoids are very common (more so that you think)
• People over the age of 50 are more likely to develop this condition. In fact, it is estimated that more than half the US population over the age of 50 suffers from this malady.
• Of this percentage, only a small number of people choose to go in for medical treatment

Do you really want to be stuck with this condition as long as you live? Do you want to dance to its horrible tune and give up all hopes for a normal life? If not, it’s time you took some decisive action and turned towards H-Miracle.

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