What does banding of piles involve?
A pile is a swollen piece of anal lining. The upper anus where internal piles form is fairly insensitive, so internal piles can often be treated without anaesthesia or with local anaesthetic.
Banding involves slipping a tiny rubber band around the neck of an internal pile. The band cuts off the blood supply to the pile. After a week or so the dead pile falls off, together with the band. Both the pile and the band disappear into the lavatory with a bowel action. The patient seldom notices this.
Banding takes a few minutes and is done in my rooms. An injection of local anaesthetic beforehand helps to make the procedure painless. It is given into the insensitive bowel lining and cannot be felt. After a few minutes the anaesthetic works and the bands can be applied. For a few hours afterwards, the patient can often feel the tiny swollen piles inside the anus. This is usually uncomfortable and seldom painful.
Which piles are suitable for banding?
Piles which are large enough to slip out after a bowel action and then go back on their own will usually improve after banding.
If piles are so large that you have to push them back, surgical removal usually gives more predictable results. However, because banding is much simpler it may be worth trying. It sometimes works unexpectedly well.
What to expect after banding
If banding eliminates your symptoms completely you need no further treatment.
If banding helps but does not remove your symptoms completely, repeating it at a later date may improve things further. It takes a while for the minor injury caused by banding to resolve, so one waits three weeks or more before repeating the procedure.
If banding does not help you at all, you need to consider surgery for your piles.
What complications can this treatment cause?
People with poor immune function (caused by AIDS or immunosuppressive drugs after a transplant) can develop a dangerous infection, so should not have this treatment. Infection is very rare in healthy people. The bands occasionally cause bad anal pain, usually if the piles are very large, but this does not mean that the piles do not respond to the treatment.
What to expect after you have bands applied.
Inside your anus you will probably feel the lumps which are the banded bits of bowel lining. Each lump is about the size of a pea. It feels a bit like having three peas pushed into your anus. It is usually an uncomfortable feeling. It seldom hurts.
After a few hours the local anaesthetic wears off and you may feel an ache in the anus. You can usually prevent the ache if you take pain killers as prescribed, starting just after the bands are applied.
Most people say that their anus feels almost back to normal the day after the procedure. It is rare to have bad pain.