HEMORRHOID BANDING

General Information

DEFINITION--Removal of hemorrhoids by a technique that uses a rubber band over the stalk of the hemorrhoid to cut off blood flow.

BODY PARTS INVOLVED--Anus; rectum; dilated veins in anus and rectum (hemorrhoids).

REASONS FOR SURGERY

• Pain, excessive bleeding, itching or prolapse of dilated veins in the rectum and anus.
• Relief of a painful thrombosed hemorrhoid (hemorrhoid containing a blood clot).

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Excess alcohol consumption.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.

What To Expect

WHO OPERATES--Proctologist, colon-rectal surgeon or general surgeon.

WHERE PERFORMED--Hospital or outpatient surgical facility.

DIAGNOSTIC TESTS

• Before surgery: Blood studies.
• After surgery: Blood studies.

ANESTHESIA

• Local anesthesia by injection.
• Spinal anesthesia by injection.
• General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• The doctor inserts a proctoscope to dilate the anal muscles. Sometimes anal muscles must be dilated vigorously to expose the hemorrhoids.
• The hemorrhoid is visualized and grasped with a special instrument.
• A small rubber band is slipped over the stalk of the hemorrhoid to bind it and cut off blood flow.
• The surgical area may be sewn closed or left open, and medicated gauze is used to cover it.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Severe pain, especially with bowel movements.

AVERAGE HOSPITAL STAY--0-1 day.

PROBABLE OUTCOME--Curable in most patients, no matter what age. Allow about 2 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• No smoking.
• Warm baths about every 4 hours and following bowel movements to relieve pain and help keep the rectal area clean. Sit in warm water for 10 to 20 minutes as often as it feels good.
• Avoid heavy lifting. If not possible, learn proper body mechanics to reduce strain contributing to recurrence.
• Don't strain with bowel movements or urination.
• Wipe gently after bowel movements with soft, moist, white toilet paper or absorbent, moist cotton.

MEDICATION---

Your doctor may prescribe:

• Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need. > Stool softeners or laxatives to prevent constipation. > Analgesic ointment to relieve pain. > Vitamins to encourage healing. > Avoid aspirin.

ACTIVITY

• Resume driving 1 week after returning home.
• Resume sexual relations as soon as you wish.

DIET

• No special diet. Increase dietary fiber and fluid intake to prevent constipation. Straining during bowel movements can cause hemorrhoids to recur.
• Vitamin and mineral supplements (sometimes).

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increase in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You become constipated.