Haemorrhoid Banding - Exceptional healthcare, personally delivered - North Bristol NHS Trust

Haemorrhoid
Banding

  Exceptional healthcare, personally delivered

Introduction
    This leaflet describes what haemorrhoids are and what causes
    them. It discusses lifestyle changes to avoid them as well as
    details of haemorrhoid banding including risks, benefits and
    aftercare.

    Haemorrhoids (piles)
    Haemorrhoids (piles) are enlarged blood vessels in the lining of
    the anus and lower rectum (back passage). These can become
    irritated causing bleeding, itching, discomfort, and sometimes
    can protrude from the back passage. Haemorrhoids are often
    small and symptoms settle down without treatment. But there
    are times when treatment is required.

    What causes them?
    About half the people in the UK develop one or more
    haemorrhoids at some stage. Certain situations increase the
    chance of haemorrhoids developing.

    Constipation, passing large stools (faeces) and straining at the
    toilet. These increase the pressure in and around the veins in
    the anus and seem to be a common reason for haemorrhoids to
    develop.

    Pregnancy. Haemorrhoids are common during pregnancy. This
    is probably due to the pressure effects of the baby lying above
    the rectum and anus and the effect that changes in hormones
    during pregnancy can have on the veins.

    Aging. The tissue in the lining of the anus may become less
    supportive as we get older.

    Hereditary factors. Some people may inherit a weakness of the
    wall of the veins in the anal region.

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What is the treatment for haemorrhoids?
Keep the faeces (sometimes called stools or motions) soft and
don’t strain on the toilet. You can do these by the following:
 nn Eat plenty of fibre such as fruit, vegetables, cereals and
    wholemeal bread etc.
 nn Have lots to drink. Adults should aim to drink at least two
    litres (10 – 12 cups) per day. You will pass much of this
    fluid as urine, but some will be passed out in the gut and
    softens faeces. Most sort of drink will do but alcoholic
    drinks can be dehydrating and may not be so good.
 nn Avoid painkillers that contain codeine such as co-codamol
    as they are a common cause of constipation.
 nn Toileting. Go to the toilet as soon as possible after feeling
    the need. Some people suppress the feeling and plan to
    get to the toilet later. This may result in bigger and harder
    faeces forming which are more difficult to pass. Avoid
    constipation and straining at the toilet.

Banding Treatment
Banding is a common treatment for haemorrhoids. It may be
used to treat haemorrhoids which have not settled with the
measures above (such as increase in fibre etc).
A surgeon in the outpatient clinic usually does this procedure.
A suction device grasps each haemorrhoid and a rubber band
is placed at the base which cuts of the blood supply to the
haemorrhoid. This causes the haemorrhoid to shrink leaving the
dead tissue to drop off over a period of up to 10 days.
Banding of internal haemorrhoids is usually painless as the base
of the haemorrhoid originates above the anal opening – the very
last part of the gut lining is not sensitive to pain. Up to three
haemorrhoids may be treated at one time using this method.

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Benefits
    In about 8 in 10 cases the haemorrhoids are ‘cured’ by this
    technique. In about 2 in 10 cases the haemorrhoids recur at some
    stage. However, you can have further banding treatment if this
    occurs. Haemorrhoids are less like to recur after banding if you
    do not become constipated and do not strain on the toilet as
    described earlier.

    Risks
    A small number of people have complications following banding
    such as bleeding, urinary problems, infection or ulcers forming at
    the site of a treated haemorrhoid. If you see a lot of fresh bright
    red blood or pass clots you should seek urgent medical attention.

    What to expect with Haemorrhoid banding
    recovery.
    When haemorrhoid banding is finished, expect to feel:

     nn Pain from anywhere from 24 to 48 hours.
     nn The sensation of fullness in the lower abdomen.
     nn That you need to have a bowel movement.

    You may also find it difficult to urinate and to control gas or
    bowel movements for a few days. Also expect to have bleeding
    for up to 14 days after the treatment. The bleeding may get worse
    at 7 – 10 days when the banded haemorrhoid drops off. The
    wound normally takes about two weeks to heal. However, you will
    have no more itching, painful, bleeding haemorrhoids.

    Aftercare
    You may experience some discomfort after the banding. You
    should take regular painkillers such as paracetamol if you need to.
    Avoid strenuous exercise for the rest of the day, e.g. avoid sport,
    jogging or riding a bike.
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You can bath or shower as you wish.
You should be able to get back to your normal life the next day.
If you need a follow up appointment in clinic it will be arranged
at the time, or often you can be referred back to your GP.

References
Haemorrhoids. Clinical Knowledge Summaries. Available at
www.cks.nhs.uk/patient_information_leaflet/haemorrhoids
[Accessed June 2009]
Acheson, AG and Scholfield, JH 2008. Management of
haemorrhoids. BMJ. Feb 16: 336 (7640) 380-3
Brsinda G. 200. Prevention is best; haemorrhoidectomy needs
skilled operators. BMJ. Sep 9; 321 (726) 852-3
NICE 2007 Haemorrhoid- stapled haemorrhoidopexy. Available
at http://guidance.nice.org.uk/TA128 [Accessed June 2009]

NHS Constitution. Information on your rights and responsibilities.
Available at www.nhs.uk/aboutnhs/constitution

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www.nbt.nhs.uk

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© North Bristol NHS Trust. This edition published November 2016. Review due November 2018. NBT002106