Rubber band ligation (Barron’ s procedure) is a very easy, effective and painless treatment for second- or third-degree hemorrhoids. It is performed over 100 years with very good results and very few complications. It is widely used in NHS outpatient department.

A detailed clinical examination and complete proctoscopy is necessary before proceeding with this treatment. Only internal hemorrhoids with an obvious stalk are suitable. This procedure does not require any anesthesia and is achieved at the proctologist’s office. It takes about ten minutes to complete rubber band ligation. Elastic bands are applied to the base of hemorrhoids through a proctoscope and their blood supply is interrupted. The method is painless because there are no nerves where bands are applied. Usually two haemorrhoids can be ligated at each visit. When hemorrhoids shrink completely  (usually 3-4 days after the procedure) the elastic bands fall away. The fibrosis which results after this procedure keeps the hemorrhoids in place and prevents their protruding. 

Usually there are no patient complaints after rubber band ligation. There may be a slight urge for defecation or pain. Warm sitz baths and analgesics are sufficient to relieve symptoms. A temporary and mild bleeding may occur when elastic bands fall. It heals spontaneously and does not require any intervention.

If there any remaining hemorrhoids, they are treated after 3-4 weeks.

Long term results of this procedure are very encouraging. Surgical treatment of hemorrhoids may have better and more permanent results, but it is an invasive procedure which requires anesthesia, has a longer convalescence and has a greater incidence of complications.