Rubber-band ligation is contraindicated for the following:
Patients using anticoagulants
Patients with a septic process in the anorectal region (eg, perianal abscess, proctitis, or colitis)
Patients with acutely thrombosed hemorrhoids
Patients with large grade IV hemorrhoids
Patients with hypertrophied anal papilla
Patients with chronic anal fissure (surgical treatment is more appropriate in such cases)
Cases in which insufficient tissue is available to be pulled inside the band ligator drum
Hemorrhoid ligation is performed for first-degree, second-degree, and some cases of third-degree hemorrhoids when the patient complains of bleeding or prolapse of hemorrhoids. Band ligation may also be considered for bleeding in severely anemic patients with fourth-degree hemorrhoids who are unfit for surgery.
Most complications of the procedure are minor and self-limiting; they can be managed on an outpatient basis. Complications of rubber-band hemorrhoid ligation include the following:
Vasovagal symptoms (dizziness and fainting)
External hemorrhoid thrombosis (2%-3%)
Usually, one or two hemorrhoids are ligated at a time. Any remaining hemorrhoids may be ligated after a period of 4-6 weeks.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Praveen K. Roy. Skill Checkup: Rubber-Band Ligation of Hemorrhoids - Medscape - May 09, 2019.