Piles Ligation

What is piles ligation?

Piles ligation, also known as rubber band ligation, is a non-surgical procedure to treat internal haemorrhoids that protrude during bowel movement. A small rubber band is used to tie off the base of the haemorrhoid. This cuts off the blood supply to the haemorrhoid, causing the haemorrhoid to die and fall off in a few days and the wound to heal within one to two weeks. A scar will be formed in the place of the haemorrhoid. It holds the surrounding veins to prevent them from bulging into your anal canal.

How is piles ligation carried out?

Your doctor inserts an anoscope into your anus to look inside your anus and rectum. Another special instrument is used to grasp the haemorrhoid and a device places a rubber band around the base of the haemorrhoid.

Who should undergo piles ligation?

If your piles are not prolapsed, piles ligation would be suitable to treat your condition. Piles ligation is commonly performed for recurrent haemorrhoids that cause significant pain, such as second degree haemorrhoids. It is a simple procedure that can be done in the doctor’s office or as an outpatient case.

Piles ligation is generally highly effective for second degree haemorrhoids, with 8 in 10 people recovering fully. One to two haemorrhoids can be removed in a single procedure, and another procedure can be carried out after 4 to 6 weeks. It prevents the piles from returning and repeat treatment is not needed. However, this procedure is not suitable for third or fourth degree haemorrhoids where your piles has prolapsed and require surgery. Haemorrhoidectomy may be recommended in these cases.

What to expect?

Before the surgery

  • Stop current medications a week before the procedure as instructed by your doctor.
  • You may be given bowel fleet or laxatives to clear your bowels the day before your procedure.
  • You may have to fast as instructed.

During the surgery

  • You may be placed under a short anaesthetic or sedation.
  • Your doctor will gently insert an anoscope into your anus to examine your rectum.
  • A specialised instrument will be used to grasp the haemorrhoid
  • A device is used to roll the rubber band(s) onto the base of your haemorrhoid.
  • The procedure will take around 10 minutes to be completed.

After the procedure

  • You may feel pain and have a sensation of fullness in your lower abdomen, or may feel like you need to have a bowel movement. Most of the pain will go away 24 to 48 hours after the procedure.
  • If the rubber band(s) feel too tight, medication can be applied or injected to the banded area to ease the pain or discomfort.
  • Painkillers may be prescribed to help you reduce the pain.
  • You may bleed at your anus a few days after the surgery when your haemorrhoid falls off. Bleeding will stop on its own.
  • You may be prescribed stool softeners and laxatives.
  • Drink more fluids to for smooth bowel movement.
  • You may be able to return to normal activities within two to three days of bed rest.
  • Avoid lifting heavy objects and straining during bowel movement to aid recovery.
  • Sit in a shallow tub of warm water (sitz bath) for 15 to 20 minutes thrice a day to ease the discomfort.