Rubber Band Ligation for Hemorrhoids: Does It Hurt, How It Works & What to Expect
November 24, 2025
Hemorrhoids are uncomfortable, frustrating, and sometimes even alarming, especially when hemorrhoids cause bleeding or interfere with daily life. If diet changes, over-the-counter creams, or home remedies haven’t helped, your doctor may recommend rubber band ligation, one of the most effective office-based treatments for internal hemorrhoids.
But before scheduling the procedure, patients usually have several questions:
- What is rubber band ligation?
- Does rubber band ligation hurt?
- Can hemorrhoids come back after rubber band ligation?
- What is recovery like?
- Can I do rubber band ligation at home?
This comprehensive guide covers everything you need to know in simple, patient-friendly language.
What Is Rubber Band Ligation?
Rubber band ligation, also known as Hemorrhoid Banding, is a minimally invasive, non-surgical treatment used to remove internal hemorrhoids. The procedure works by placing a small rubber band around the base of the hemorrhoid, cutting off its blood supply. Within a few days, the hemorrhoid shrinks, dries out, and falls off naturally during a bowel movement.
Who is it for ?
Rubber band ligation is recommended for:
- Internal hemorrhoids Grades 1–3
- Hemorrhoids that bleed
- Hemorrhoids that protrude but retract on their own
- Patients who want a quicker recovery than surgery
It is not used for:
- External hemorrhoids
- Thrombosed hemorrhoids (painful clots)
- Severe Grade 4 hemorrhoids
The procedure is performed by a gastroenterologist or colorectal specialist in an office setting, usually in just a few minutes.
How Does Hemorrhoid Banding Work?
Here’s a simple, step-by-step explanation:
1. Examination
The doctor uses a small scope (anoscope) to view the hemorrhoid clearly.
2. Band placement
A tiny medical instrument gently suctions the hemorrhoid and places a small rubber band around its base.
3. Blood supply stops
The band cuts off circulation to the hemorrhoid, causing it to shrink.
4. Hemorrhoid falls off naturally
Within 3–7 days, the banded tissue dries out and detaches, usually unnoticed.
Patients typically return home right after the procedure and can resume normal activities the same day.
Does Rubber Band Ligation Hurt?
This is the #1 question patients ask, and the answer may surprise you.
Most patients feel pressure, not pain.
Internal hemorrhoids sit in an area with very few pain-sensitive nerves. Because of this, rubber band ligation is generally well-tolerated and minimally painful.
What you may feel:
- Mild pressure
- A sense of fullness
- A temporary urge to have a bowel movement
These sensations usually last only a short time.
Why do some people feel pain
Pain is more likely if:
- The band is placed too low (near nerve-sensitive skin)
- Multiple hemorrhoids are banded in one session
- You have severe hemorrhoids
If there is significant pain, the band can be adjusted immediately.
Pain management is simple
Most patients only need:
- A warm sitz bath
- Acetaminophen
- Increased fiber and hydration
Stronger pain is rare and should be evaluated promptly.
What to Expect During the Procedure
Rubber band ligation is quick, usually 1–5 minutes per hemorrhoid, and does not require anesthesia.
During the procedure, you’ll:
- Lie comfortably on your side or back
- Feel a small amount of pressure
- Experience minimal to no pain
- Be able to walk out afterward
Most patients describe it as:
“Uncomfortable for a moment, but not painful.”
It is significantly easier to tolerate than surgical hemorrhoidectomy.
Hemorrhoid Banding Recovery Guide
Most patients recover smoothly. Here’s what to expect:
First 24–48 hours
- Mild pressure or discomfort
- Slight bleeding
- Possible urge to have a bowel movement
Days 3–7
- Hemorrhoid shrinks
- Banded tissue falls off naturally
- Small spotting or bleeding is normal
7–14 days
- Symptoms improve
- Swelling decreases
- Daily activities continue normally
Tips for a smoother recovery
- Drink plenty of water
- Eat high-fiber foods (fruits, veggies, whole grains)
- Take a fiber supplement
- Avoid straining
- Use sitz baths for comfort
- Avoid heavy lifting for a few days
If pain is severe or bleeding is heavy, contact your doctor.
Can a Rubber Band Fall Off Prematurely?
Yes, it can happen, but it’s uncommon.
Signs it fell off early:
- Mild bleeding
- Sudden relief of pressure
- Passing the band during a bowel movement
Is it dangerous?
Not usually.
However:
- The hemorrhoid may not shrink fully
- You may need a second session
- Contact your doctor if bleeding is heavy or continuous
Most premature detachments still lead to improvement.
Can Hemorrhoids Come Back After Rubber Band Ligation?
Yes, hemorrhoids can recur, but the risk is relatively low.
Recurrence Facts:
- 10–20% experience recurrence within 2–5 years
- Recurrence is higher if the underlying causes aren’t addressed
Common causes of return symptoms:
- Chronic straining
- Constipation
- Sitting too long
- Low-fiber diet
- Pregnancy
- Frequent heavy lifting
How to prevent recurrence
- Increase fiber
- Stay hydrated
- Avoid straining
- Take breaks during long sitting sessions
- Maintain healthy bowel habits
Can You Do Rubber Band Ligation at Home?
Absolutely not, and it’s dangerous.
Rubber band ligation must be performed by a physician. Attempting this at home can cause:
- Severe pain
- Heavy bleeding
- Infection
- Tissue death (necrosis)
- Emergency complications
DIY hemorrhoid banding products are unsafe and should never be used.
Always seek professional treatment.
Rubber Band Ligation for Female Patients: Pregnancy, Postpartum & Colonoscopy
Women often experience hemorrhoids due to:
- Pregnancy
- Childbirth
- Hormonal changes
- Chronic constipation
Is RBL safe for women?
Yes, for most women, including those who are postpartum.
Considerations:
- Some pregnant women may need to delay banding until after delivery
- If hemorrhoids were discovered during a colonoscopy, they can often be treated in the same session
- Pelvic floor disorders may require combined treatment
A specialist will evaluate the safest option based on symptoms.
Rubber Band Ligation vs Other Hemorrhoid Treatments
Here’s how RBL compares to other options:
Lifestyle & OTC Remedies
- Reduces symptoms
- Does NOT remove hemorrhoids
Minimally Invasive Options
- Infrared coagulation
- Sclerotherapy
- Rubber band ligation, most effective for Grades 1–3 hemorrhoids
Surgery (Hemorrhoidectomy)
- Best for severe Grade 4 hemorrhoids
- Longer recovery
- More painful
- High success rate
Rubber band ligation hits the “sweet spot”, effective, quick, and with minimal downtime.
When to See a Specialist
Seek professional evaluation if you experience:
- Rectal bleeding
- Persistent itching or irritation
- Lumps that don’t go away
- Painful bowel movements
- Protruding (prolapsed) hemorrhoids
- Recurring symptoms
Early treatment prevents complications and improves comfort.
Conclusion
Rubber band ligation is one of the most effective, quickest, and least painful treatments for internal hemorrhoids. Most patients feel mild pressure rather than true pain; recovery is smooth, and results are long-lasting when paired with good bowel habits.
If you’ve been struggling with hemorrhoids and want to know whether rubber band ligation is right for you, and whether it can make hemorrhoids go away, speaking with a specialist can help you understand your best treatment options.
FAQs About Rubber Band Ligation
1. Does rubber band ligation hurt?
Most patients feel mild pressure, not pain.
2. How long does hemorrhoid banding pain last?
Discomfort usually lasts 24–48 hours.
3. How long does hemorrhoid band ligation recovery take?
Most people resume normal activities the same day; the hemorrhoid falls off in 3–7 days.
4. What if the hemorrhoid band falls off early?
Mild bleeding can occur; contact your doctor if bleeding is heavy.
5. Can hemorrhoids come back after rubber band ligation?
Yes, but recurrence rates are low with proper bowel habits.
6. Is it safe for women?
Yes, including postpartum patients. Pregnancy may require timing adjustments.
7. Can I do rubber band ligation at home?
No, it’s unsafe and can cause serious complications.
8. Is rubber band ligation better than surgery?
For Grades 1–3 internal hemorrhoids, it’s the preferred option with faster recovery.
9. How long does the rubber band ligation procedure take?
Usually, 1–5 minutes per hemorrhoid. Connect with an experienced professional for more further information.
10. Can I walk or work afterward?
Yes, most patients return to normal activities immediately. However, it’s recommended to get proper rest before resuming your regular activities.