Banding of haemorrhoids (Rubber band ligation of haemorrhoids)

A quick outpatient procedure where a small rubber band is placed around the base of a haemorrhoid (pile) to cut off its blood supply, so it shrinks and drops off over a couple of weeks.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

A small rubber band is placed around an internal haemorrhoid so it shrinks and drops off over a couple of weeks; it is usually quick and done without anaesthetic.
It works best for smaller internal piles and is less suitable for large or external ones, which may need a different procedure.
Haemorrhoids can come back and more than one session is sometimes needed; in trials, recurrence within a year is higher after banding than after artery ligation.
It treats the piles you have now, not the constipation or straining that cause them, so fibre, fluids and good toilet habits matter for a lasting result.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeMinor procedure (outpatient)

AnaestheticUsually none; the area treated has few pain nerves

How long it takesA few minutes

Hospital stayOutpatient; you go home straight away

Time off workUsually little or none; many people return to normal activity the same day

When you'll see resultsSymptoms often improve over a couple of weeks as the pile shrivels and drops off

On the NHS?Commonly available on the NHS when self-care has not worked; private care is used for speed or choice

A general guide. Your surgeon will give you advice for your situation.

Best fit

Quick outpatient procedure, usually without anaesthetic and with no cut or stitches

Pause if

Large, mainly external haemorrhoids, which respond poorly to banding and may need a different treatment.

Main recovery point

You may feel a dull ache, fullness or an urge to open your bowels. Simple painkillers help. Most people go straight home and resume normal activity.

Good aftercare

Clear advice on what bleeding is normal and what counts as too much, with a named contact.

First few hours

You may feel a dull ache, fullness or an urge to open your bowels. Simple painkillers help. Most people go...

First few days

Discomfort usually settles. Keep stools soft with fibre and fluids to avoid straining. A little bleeding can occur.

About 7–10 days

The banded haemorrhoid shrivels and drops off, often with a small amount of bleeding when you open your bowels...

A few weeks

Symptoms often improve as the area heals. You may be reviewed, and further banding can be arranged if needed.

Medical line illustration of lower rectum and anal canal treatment anatomy for Banding of haemorrhoids. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is banding of haemorrhoids?

Haemorrhoids (piles) are swollen blood vessels inside or around the back passage. They can cause bleeding, itching, discomfort or a feeling of fullness.

Banding, also called rubber band ligation, is a quick procedure usually done in an outpatient clinic. A small rubber band is placed around the base of an internal haemorrhoid. This cuts off its blood supply, so over the next couple of weeks the haemorrhoid shrivels and drops off, and the small wound heals over. It is usually done without anaesthetic because the area where the band is placed has few pain nerves.

Banding works best for smaller, internal haemorrhoids that have not settled with self-care such as more fibre, fluids and creams. It is less suitable for large or external haemorrhoids, which may need a different procedure or an operation.

Banding can ease symptoms well, but haemorrhoids can come back, and more than one session is sometimes needed. It treats the haemorrhoids you have now; it does not change the habits, such as straining and constipation, that help them form, so these matter for a lasting result.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Single haemorrhoid banding

One haemorrhoid is banded in a session. The number treated at once depends on the clinician's preference and your comfort.

Multiple-band session

Some clinicians place more than one band in a single visit. This can mean fewer appointments but a little more discomfort afterwards.

Repeat banding sessions

Banding is often planned as a course over several visits a few weeks apart, treating different haemorrhoids or repeating treatment if symptoms persist.

Banding with a proctoscope

A short, lubricated tube (proctoscope) is used to see the haemorrhoids and apply the band accurately. This is the usual way the procedure is done.

Banding vs artery ligation (HALO)

Point	Banding	Artery ligation (HALO)
Setting	Outpatient clinic	Theatre, often general anaesthetic
Anaesthetic	Usually none	Usually general or spinal
Short-term pain	Usually less	Usually more
Coming back within a year	Higher in trials	Lower in trials

In the HubBLe trial, recurrence within a year was higher after banding than after artery ligation, but banding caused less short-term pain and avoids a general anaesthetic. Your clinician will advise what suits you.

Preparing for your procedure

See a clinician who examines the back passage to confirm the cause and check the haemorrhoids are suitable for banding.
Tell them about all medicines, especially blood thinners, as these increase the risk of bleeding and may need adjusting.
Mention any bleeding from the bottom that has not been investigated, as the cause should be confirmed first.
You usually do not need bowel preparation or fasting, but follow any instructions the clinic gives.
Plan to take it easy for the rest of the day, though many people return to normal activity straight away.
Keep up fibre and fluids beforehand to keep stools soft and reduce straining.

What happens

Banding is usually done in an outpatient clinic and takes only a few minutes. You lie on your side or in another position the clinician suggests. A short, lubricated tube (proctoscope) is gently passed into the back passage so the clinician can see the haemorrhoids.

A small applicator places a rubber band around the base of an internal haemorrhoid. This is usually done without anaesthetic because the area has few pain nerves, though you may feel a dull ache or a sensation of needing to open your bowels. One or more haemorrhoids may be banded in the visit.

There is no cut and no stitches. You can normally get up and go home straight away, and most people drive themselves home and return to their usual activities the same day.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Large, mainly external haemorrhoids, which respond poorly to banding and may need a different treatment.
Bleeding from the bottom whose cause has not been investigated, which should be assessed first.
People on blood thinners that cannot be safely adjusted, because of the bleeding risk.
A weakened immune system or other factors that raise the risk of a serious infection, needing careful assessment.

Delay or rearrange if…

There is unexplained rectal bleeding or a change in bowel habit that needs investigating first.
You are on blood thinners that have not been reviewed.
There is active infection or significant inflammation in the area.
You are or might be pregnant and the procedure is not urgent.
Symptoms suggest something other than simple internal haemorrhoids.

Alternatives to discuss

Self-care: more fibre, plenty of fluids, not straining, and short-term creams or ointments.
Other outpatient treatments such as injection sclerotherapy or infrared coagulation.
Haemorrhoidal artery ligation (HALO) for higher-grade or recurrent haemorrhoids.
Surgery (haemorrhoidectomy or stapled haemorrhoidopexy) for large or persistent haemorrhoids.
Treating constipation and reviewing diet rather than a procedure for mild symptoms.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

Quick outpatient procedure, usually without anaesthetic and with no cut or stitches
Can relieve bleeding, itching and discomfort from internal haemorrhoids
Many people return to normal activity the same day
Avoids a general anaesthetic and a hospital stay
Can be repeated if symptoms persist or another haemorrhoid needs treating

Risks & complications

More common

A dull ache or feeling of fullness or needing to open your bowels for a day or two
A small amount of bleeding, especially when the haemorrhoid drops off after about a week to ten days
Mild discomfort that simple painkillers such as paracetamol help
Symptoms not fully settling, so further sessions are needed

Less common

Heavier bleeding, sometimes a week or two later when the haemorrhoid separates
A band slipping off or being passed before it has worked
Difficulty passing urine for a short time
Haemorrhoids coming back and needing repeat treatment

Rare but serious

Significant bleeding needing medical attention or a procedure
A serious pelvic infection (very rare), which can cause severe pain, fever and difficulty passing urine
An ulcer or fissure at the band site

The most important risk to recognise is delayed bleeding when the haemorrhoid drops off after about a week to ten days; a small amount is normal, but heavy bleeding needs urgent advice. Very rarely, a serious pelvic infection can develop, so severe pain, fever, feeling very unwell or difficulty passing urine should be treated as an emergency. Any unexplained bleeding from the bottom should be properly investigated before assuming it is just piles. Blood thinners increase bleeding risk and should be discussed.

Published figures to discuss

Banding is generally low-risk, but recurrence is common and depends on the grade of haemorrhoids, the number treated and lifestyle factors. The figures below come mainly from the HubBLe randomised trial and complication reviews, and should be read as ranges rather than promises.

Figure	Reported range	How to interpret it	Source / confidence
Recurrence within about a year	49% at 1 year in the rubber-band ligation arm of the HubBLe trial	Higher than haemorrhoidal artery ligation in the same trial (30%); repeat banding is often part of treatment.	Rubber band ligation complications review (WJGS)wjgnet.comPublished figure
Bleeding (including delayed bleeding)	Minor bleeding is common; significant bleeding is uncommon, around 1% in some complication series	Delayed bleeding classically occurs about 10–14 days after banding when the haemorrhoid sloughs; risk is higher with antiplatelets or anticoagulants.	Rubber band ligation complications review (WJGS)wjgnet.comPublished figure
Serious pelvic infection	Very rare; mainly case-report level rather than a stable percentage	Severe pain, fever or difficulty passing urine after banding is an emergency.	Rubber band ligation complications review (WJGS)wjgnet.comSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Recovery is usually quick. Many people return to normal activity the same day, with some mild discomfort and the knowledge that the haemorrhoid will drop off, often with a little bleeding, after about a week to ten days.

First few hours

You may feel a dull ache, fullness or an urge to open your bowels. Simple painkillers help. Most people go straight home and resume normal activity.

First few days

Discomfort usually settles. Keep stools soft with fibre and fluids to avoid straining. A little bleeding can occur.

About 7–10 days

The banded haemorrhoid shrivels and drops off, often with a small amount of bleeding when you open your bowels. This is usually normal, but heavy bleeding needs advice.

A few weeks

Symptoms often improve as the area heals. You may be reviewed, and further banding can be arranged if needed.

What's normal — and not a worry

A dull ache or sense of fullness for a day or two
A small amount of bleeding, especially around the time the haemorrhoid drops off
A short-lived feeling of needing to open your bowels
Symptoms easing over the following weeks, sometimes after more than one session

Aftercare

Take simple painkillers such as paracetamol for any ache; ask before using ibuprofen if you have bleeding.
Keep stools soft with plenty of fibre and fluids, and avoid straining on the toilet.
Expect a little bleeding, especially around a week to ten days when the haemorrhoid drops off.
Avoid heavy lifting and strenuous exercise for a day or two if you feel sore.
Restart blood thinners only as advised by the clinician.
Know who to contact and what to do if you have heavy bleeding, severe pain or fever.
Continue good toilet habits and fibre afterwards to reduce the chance of piles returning.

Before your procedure

Simple painkillers at home
Fibre and plenty of fluids to keep stools soft
Awareness that a little bleeding around day 7–10 is normal
A plan for blood thinners if you take them
The clinic contact number saved in case of heavy bleeding or severe pain
A quieter rest of the day planned, just in case

Scars and how they heal

There is no surgical cut, so there is no scar. A small raw area is left where the banded haemorrhoid drops off, which heals over on its own. Some bleeding from this area when you open your bowels is normal in the first week or two.

⚠ Get urgent help if…

Heavy bleeding from the bottom, or passing large clots
Severe or worsening pain in the bottom or pelvis
A high temperature, chills or feeling very unwell
Difficulty passing urine or being unable to pass urine
Feeling faint, dizzy or breathless
Tummy or pelvic pain with fever — seek urgent help, as a serious infection is rare but important

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result means the banded haemorrhoid shrinks and drops off and your symptoms, such as bleeding or discomfort, improve. NHS information suggests banding helps in a high proportion of people, though some find symptoms return.

Banding treats the haemorrhoids present now, but it does not stop new ones forming or change the straining and constipation that cause them. Recurrence is possible, and more than one session is sometimes needed. Any bleeding from the bottom should still be properly assessed, as banding should not be used to treat bleeding whose cause has not been confirmed.

How long it lasts

Banding can give lasting relief, but haemorrhoids can come back over time. In the HubBLe trial, recurrence within a year was higher after banding than after artery ligation, and some people need repeat sessions or a different treatment later. Keeping stools soft, avoiding straining and maintaining a high-fibre diet help reduce the chance of piles returning.

Related tests, treatments or support

Banding is often part of a wider plan that includes self-care measures such as more fibre, fluids and good toilet habits. If banding does not control symptoms, or the haemorrhoids are large or external, other options such as artery ligation (HALO) or surgery may be discussed.

Follow-up & long-term care

You may be reviewed after a few weeks to check your symptoms and decide whether further banding or another treatment is needed. If bleeding continues or new symptoms appear, the cause should be reassessed rather than assumed to be piles.

Keep a high-fibre diet and drink plenty of fluids
Avoid straining and prolonged sitting on the toilet
Treat constipation early
Seek review if symptoms return or new bleeding occurs

Repeat, follow-on and what comes next

Banding is often planned as a course of several sessions rather than a single treatment.
Haemorrhoids commonly recur over time and may need repeat banding or a different procedure.
If banding repeatedly fails or the haemorrhoids are large, surgery may be discussed.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

Clear advice on what bleeding is normal and what counts as too much, with a named contact.
Warning signs of serious infection (severe pain, fever, trouble passing urine) clearly explained.
Advice on fibre, fluids and avoiding straining to reduce recurrence.
A plan for restarting blood thinners safely.
Review arranged to check symptoms and decide on any further treatment.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether one or several bands are placed per session
How many sessions are needed
The clinic or clinician's fee and any examination beforehand
Whether an examination of the bowel is needed to confirm the cause of bleeding
Follow-up appointments
Whether another treatment is needed if banding does not control symptoms

Make sure your written quote includes

The clinician's fee per banding session
How many sessions are included or likely to be needed
Any examination or test needed to confirm the cause of symptoms
Follow-up appointments
What happens, and any extra cost, if the haemorrhoids come back
What happens if banding does not work and another procedure is needed

On the NHS? Banding of haemorrhoids is commonly available on the NHS when self-care has not worked; private care may be used for speed or choice, but any unexplained rectal bleeding should be properly investigated first.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the surgeon is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the surgeon who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

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Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

Are my haemorrhoids the right type and size for banding?
Has the cause of my bleeding been properly checked first?
How many bands or sessions am I likely to need?
What should I expect when the haemorrhoid drops off, and what counts as too much bleeding?
If banding does not work, what would you suggest next?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my procedure, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this procedure not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Is haemorrhoid banding available on the NHS?

Yes, it is commonly available on the NHS when self-care has not controlled symptoms. Private care may be used for speed or choice. Your GP or a specialist can advise whether banding suits your haemorrhoids.

Does banding hurt?

It is usually done without anaesthetic because the area banded has few pain nerves. You may feel a dull ache or a sense of needing to open your bowels for a day or two, which simple painkillers help.

Is it normal to bleed afterwards?

A small amount of bleeding is normal, especially around a week to ten days later when the haemorrhoid drops off. Heavy bleeding or passing large clots is not normal and needs urgent advice.

Will the piles come back?

They can. Banding treats the haemorrhoids you have now but does not stop new ones forming. In trials, recurrence within a year was higher after banding than after artery ligation, and repeat sessions are sometimes needed.

Can I go back to work the same day?

Many people return to normal activity and work the same day, though you may prefer to take it easy if you feel sore. Avoid heavy lifting for a day or two if uncomfortable.

What if banding does not work for me?

If symptoms persist, the haemorrhoids are large, or they are external, other options such as artery ligation (HALO) or surgery may be considered. Discuss the alternatives with your clinician.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Piles (haemorrhoids) HubBLe trial — HAL vs rubber band ligation (The Lancet) HubBLe trial — full report (PMC) RCS England — Commissioning guide: rectal bleeding Rubber band ligation complications review (WJGS)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.