When a rubber band falls off – hemorrhoid treatment

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When a rubber band falls off – frequently-asked questions

Do you think you might have seen a rubber band fall off prematurely following your ligation and cryotherapy treatment?

During the hemorrhoid ligation procedure, two rubber bands are placed on the targeted hemorrhoidal bundle. In fact, our ligators (devices used to apply the rubber bands) are always loaded with two bands as a precaution in the rare event that one of the rubber bands should break. We also use cryotherapy to sclerose (or shrink up) the veins surrounding the hemorrhoidal bundle. The rubber bands that are applied normally fall off once the strangulated tissue becomes necrotic (dies) and are evacuated during a bowel movement anywhere from 3 to 10 days after the procedure. Because they are combined with the stool, the rubber bands are generally impossible to detect.

On occasion, a patient might notice the premature expulsion (before the usual 3-day period) of a rubber band when going to the bathroom, which can obviously raise questions:

 

Did I do something to cause this?  

No. This cannot be caused simply by having a bowel movement. It is just something that can happen if the rubber band breaks or comes loose.

 

Does this mean that the procedure did not work and that I will need ligation performed on this hemorrhoid again?  

Not necessarily. In fact, as mentioned above, two rubber bands are placed around the same hemorrhoid at the same time during the procedure. The cryotherapy treatment will also have done its job. This can be checked at your next scheduled appointment.

 

Will I have any complications if a rubber band comes off too quickly?  

It’s very unlikely. As always, the patient may notice a bit of blood, either the moment the rubber band comes off or in the days following. The bleeding is almost always minor and will stop spontaneously. We recommend avoiding significant physical exertion, including strenuous bowel movements.

 

Do I need to call to book an urgent/quick appointment?  

There is no need to make an urgent appointment since, in order to evaluate the effects of the treatment using a rectoscope (a small instrument inserted to inspect the inside of the anal canal and rectum), it is preferable to wait at least a month. Moreover, even if the treatment has failed, we need to allow the tissue to heal before we can conduct another ligation at the same site. Therefore, we suggest that you keep your scheduled appointment (or, if no appointment is scheduled, request an appointment in one month’s time). In the meantime, take note of your observations (date when the rubber band came loose, any bleeding, etc.) so you can share them with your physician at your appointment.