What Can Go Wrong With Banding Of Hemorrhoids

So you suffer from hemorrhoids and your surgeon has offered a minor procedure called "Banding Ligation of Hemorrhoids". He suggests that putting these rubber bands on your hemorrhoids is very safe and not painful. He sounds pretty relaxed about the whole thing. You are a little worried but feel too scared to ask about the complications. Even though the technique is usually safe and painless, complications do arise. Here are the more common ones:

1. Pain

This can be severe immediately after band application. It is usually caused by the surgeon putting the band too low in the anal canal. Should this be the case, the band should be removed immediately, and re-applied higher in the anal canal. Mild pain, however, is normal and usually resolves within a couple of hours. Local anesthetic can be injected into the site of the application to dampen the pain.

2. Bleeding

Some bleeding normally occurs at the first bowel movement after the procedure. Severe bleeding requiring hospitalization and blood transfusion can also happen and occurs in 1% of patients.

3. Infection and Sepsis

Infective complications of the procedure are rare but can be life-threatening. By sepsis, we mean that the bacteria from the banded tissue have invaded the bloodstream to cause a generalised infection throughout the body. Should this complication occur, hospitalization is required and potent antibiotics are given intra-venously.

4. Thrombosed hemorrhoids

In some patients, around 1 in 20, the banded hemorrhoids can become thrombosed (with their blood vessels clotted). This condition is very painful and often immediate surgery to excise these is the only way out.

5. Anal fissures and ulcers

Fissures and ulcers develop in about 1% of patients who have banding done. This is a result of sloughing of the banded tissues. Pain killers usually suffice in managing the associated pain. However, a few patients do end up requiring surgery for the fissures and ulcers.

6. Band slippage

Slippage of the band can occur if too little tissue is banded. There is no harm done, but no benefit would be expected either. In cases of band slippage, the surgeon usually repeats the procedure early.

With recent advances in other methods to handle hemorrhoids, banding is done less commonly today, even though it stays an effective treatment for mild hemorrhoids, in experienced hands.

Dr Benson Yeung's related hub: Pitfalls Of Home Treatment For Hemorrhoids