Many patients consider banding because their hemorrhoids are causing them many difficult symptoms; but it's important to state that hemorrhoid banding will only improve certain symptoms. These are bleeding, and to a much lesser extent, prolapse (the feeling of hemorrhoids protruding after a bowel movement).
If effective, banding can reduce bleeding by approximately 50%, and the improvement might last 6 - 24 months (the time it takes your body to create new, oversized hemorrhoid veins from ones that were previously normal). To notice a difference, patients will typically be experiencing bleeding on a regular basis, at least once per week. Patients who can routinely have weeks or months between episodes of bleeding will seldom benefit from banding, as the improvements will be too small to notice.
Patients who have prolapse (the sensation of hemorrhoids protruding after a bowel movement) benefit less from banding. If the hemorrhoids are outside at all times, then typically the only longterm solution is surgery. For patients who experience prolapse only after a bowel movement, the placement of bands may induce some inflammation that can reduce the amount of prolapse.
For patients experiencing raw, itchy perianal skin, the treatment is often centred around the skin itself, rather than the hemorrhoids up inside. Banding hemorrhoids up inside the rectum does nothing to improve irritated perianal skin.
Finally, patients who experiencing outright pain with a bowel movement should not undergo banding. These patients are frequently suffering from an anal fissure
, and banding will only make this much worse. The time to reassess whether or not the bands have been effective in decreasing your bleeding, will be about four weeks after the procedure.
Sometimes hemorrhoid banding is done as part of a strategy to confirm that infrequent rectal bleeding is in fact from hemorrhoids only. Hemorrhoid bands will not affect bleeding that is from cancers, colitis, or polyps. The assumption is that after the placement of the hemorrhoid bands, it will be possible a month or two later to confirm that there has been a sustained, significant decrease in the rectal bleeding. If this is the case, it goes a long way to proving that any bleeding is hemorrhoidal in nature. By the same token, rectal bleeding that is entirely unaffected by hemorrhoid bands always needs to be thoroughly investigated. Patients who have no significant response to hemorrhoid banding must follow up with their doctor.
The worst possible complication of haemorrhoid banding is infection, which is extremely rare. Any patient undergoing banding who is having increasing pain in the first week after banding should be reassessed by their doctor.
Overall, hemorrhoid banding is a useful way to treat the bleeding of moderate to severe hemorrhoids, without having to undergo more painful and invasive procedures like surgery.