Background :

Hemorrhoids are important today due to rising sedentary lifestyles, poor diets, and stress, leading to increased cases, healthcare costs, and demand for awareness and effective treatments.

Objective :

The study aimed to analyze the success of rubber band ligation in grade I, II, and III hemorrhoids, to evaluate associated complications, and to determine whether all symptomatic hemorrhoids should be treated with band ligation at the first visit.

Methods :

A prospective and descriptive study was designed for patients who attended the OPD of Chittagong Medical College Hospital from July 2007 to June 2008. Patients having large 1st degree hemorrhoids, 2nd degree, and early 3rd degree hemorrhoids were treated.

Results :

Rectal bleeding was the most common symptom (100%). Anoscopy showed 6% first degree, 86% second degree, and 8% third degree hemorrhoids.

Information on presenting symptoms, number of bands applied, response to therapy, complications encountered, number of sessions needed to improve symptoms, requirement of analgesics, follow-up of patients, and subsequent therapy were documented. Supplementary information was obtained through telephone follow-up.

Outcome was categorized as success or failure. Success was defined as permanent relief of symptoms during follow-up periods. Improvement in symptomatology was defined as rare manifestation of bleeding (< 1 month). Failure was defined as decrease but no improvement of symptoms.

In this study, 88% of patients succeeded, 6% improved, and 6% failed. 16% of patients had bleeding during defecation for < 7 days, while 8% complained of bleeding for > 7 days. Recurrence was observed in 2% of patients.

38% of patients required no analgesics. Among the 62% who required analgesics, 36.8% required them for up to 24 hours, 47.37% required them for 24?48 hours, and 3 patients required them for > 48 hours.

All patients attended the first follow-up on the 7th day, 14% missed the second follow-up at 6 weeks, and 16% missed the third follow-up at 6 months.

Conclusion :

Rubber band ligation is a quick and simple procedure requiring no anesthesia in the absence of anorectal pathologies other than hemorrhoids. Though it has some minor complications and a chance of recurrence, it is considered a safe and effective procedure for symptomatic hemorrhoids.

Keywords :

Rubber Band Ligation, Hemorrhoids.