Gastroenterology - Information and aftercare for patients requiring Rectal Banding

This leaflet has been prepared after speaking to patients who have had the procedure. It may not answer all your questions, if you have any further questions or worries please do not hesitate to ask.

If you are on warfarin – please discuss this with the Endoscopy nurse co-ordinator phone on 0161 206 5959.

Prior to banding the Endoscopist will perform a thorough examination of the left side of your bowel, this is in order to assess whether banding is required.

On arrival at the department

• A member of the nursing team will complete an initial nursing assessment
• You will be given a consent form to sign
• You will be asked to change into a gown, and given a pair of dignity shorts, all trolley areas have curtains around them
• The unit operates single sex days, therefore you will not meet patients of the opposite sex whilst you are in a hospital gown

What are haemorrhoids (‘piles’)?

The anus (back passage) is normally lined with soft fleshy tissue which is very well supplied with blood vessels.

This forms what we call haemorrhoids or piles. Due to the very good blood supply, minor scratches to the lining, such as when having the bowels open, may cause bleeding or irritation from the piles.

In some cases, often because of problems with passing motions, the blood supply to the anus is increased and the amount of lining tissue is gradually increased over time.

How does banding treatment work?

When the piles are large and fleshy, it is possible to pass a tiny rubber band over the pile. This constricts the pile, cutting off the blood supply to it. Over a few days the pile then shrivels up and eventually falls off like dead skin.

What to expect afterwards

Immediately after the banding there may be a mild discomfort in the back passage and there is frequently some bleeding from the haemorrhoid. This is normal - do not worry.

You may feel a little lightheaded shortly after the procedure.

Over the next few days, the pile often becomes irritated and a little swollen. You may feel a lump in the anus and a discomfort especially when going to the toilet. If this is bothersome, you may take some mild painkillers such as Paracetamol to help.

As the pile shrivels up it falls off after a week or so and there is often a small amount of bleeding. Don’t worry - this is normal

Potential complications of the treatment

Occasionally, the band constricts a part of the lining of the back passage which is very sensitive. This usually shows as severe pain and irritation of the anus. There is also a rare risk of infection or ulcers forming at the site of a treated haemorrhoid.

When to be seen again

There is sometimes no need to be seen routinely after banding treatment unless other investigations or repeated treatments are planned. If there is severe pain in the back passage or persisting or heavy bleeding, you may need to be seen for a check-up or removal of the band.

How to prevent the haemorrhoids recurring

A good bowel habit is the key to preventing haemorrhoids from forming.

The main ‘rules’ are:

1. Prevent the motions from being too hard. You can help to keep the motions soft by eating a diet high in fibre, drinking plenty of fluid with meals and, if necessary, taking mild laxatives such as lactulose or fybogel from the chemist.
2. Try not to strain when passing motions. Go to the toilet when you feel the urge. Different people have different numbers of bowel action in a day. Don’t try and strain to have a bowel action unless you feel the urge to and don’t try too hard to ‘push out every little bit’.
3. Don’t spend too long on the toilet. When sitting down, the weight of the body pushes down into the pelvis and will cause the lining of the back passage to swell. Aim to spend around 2 minutes sitting down when having a bowel action.

In the unlikely event that you:

• Feel feverish
• Have a large loss of blood
• Have difficulties passing urine
• Experience swelling of the anus

Then please contact the GI Unit on 0161 206 5959 between 8:30am - 5pm.

After 5pm and weekends:
Majors Area, Emergency Department on 0161 206 4848 and ask to speak to the doctor or the advanced nurse practitioner.

For more information:
Please contact the Endoscopy Unit: 0161 206 4720/0161 206 5959