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What is CRH Banding?

CRH banding is a minimally invasive hemorrhoid treatment procedure where a small tight rubber band is placed around the internal hemorrhoid tissue, causing the tissue to shrivel up and form a small scar. The result is relief of symptoms like bleeding and swelling.

How do I prepare for my CRH banding?

There are no special preparations needed for hemorrhoid banding, and normal activity is fine right after the office visit treatment.

What to expect?

The first appointment will typically consist of a consultation and limited exam. During the visit you may receive a physical examination, and an exam of the inside of the anal/lower rectal area with a short scope to see if the hemorrhoids are suitable for this type of treatment. There is no need for anesthesia, fasting or other preparation. The CRH banding may not be appropriate for all patients. You and your physician will determine an appropriate treatment for your diagnosis during your examination.

If appropriate to band the hemorrhoids, treatment may start during that initial visit. Hemorrhoids are usually in three separate areas just inside the anal opening, and usually the largest, most symptomatic hemorrhoid is banded first. Additional appointments are then scheduled to treat the remaining hemorrhoids at two-week intervals with a final check-up two or more weeks after the last remaining hemorrhoid region is banded.

What can I expect after my CRH bonding?

Following hemorrhoid banding, we recommend normal activity as tolerated, except for heavy lifting or vigorous exercise on the treatment day. You can resume full activity the next day. You can have normal bowel movements during this time, but you may want to soak in a sitz bath (a warm tub) or use a bidet for a gentler cleansing of the anal opening. Some sensation of pressure or a mild bowel urge is common for the day or so after each banding session; PAIN is quite unusual but usually minor pain relievers are fine to take if needed. You’ll need to make some changes to prevent future problems, however. Straining due to constipation should be diligently avoided, so be sure to drink seven or eight glasses of water a day and add 15 grams of fiber to your diet (two tablespoons of natural oat or wheat bran). Metamucil, Citrocel, Benefiber, flax or other soluble fiber may be helpful as well. Your doctor will advise what seems best for the condition.

We also recommend that you not sit longer than necessary on the toilet. If you can’t have a bowel movement in that time, come back later. A “two-minute rule” can help keep you from straining during bowel movements without realizing it. Finally, when traveling, stay hydrated, avoid excessive alcohol, eat fiber and walk around when you can.

Where will the CRH banding take place?

Treatments are done by the doctor in our offices.

How long does the CRH banding take?

The procedure where the scope is inserted and the banding done takes no more than a couple of minutes, with the entire visit typically is about 15-30 minutes.

What are the risks involved with a CRH banding?

Side effects are rare but include:

  • Severe pain that does not respond to the methods of pain relief used after this procedure. The bands may be too close to the area in the anal canal that contains pain sensors
  • Bleeding from the anus
  • Inability to pass urine (urinary retention)
  • Infection in the anal area

If anything unexpected is experienced, notify your physician without delay.

What are my alternatives to this procedure?

Other more complex procedure, such as Stapled Hemorrhoidopexy. This procedure was developed as an alternative to the conventional hemorrhoidectomy procedure. It involves the use of a circular stapling device that removes the hemorrhoid tissue and staples the area closed. As compared to traditional hemorrhoidectomy, this procedure is generally less painful and recovery time is quicker. The downside of this procedure is that it carries a higher risk of repeat hemorrhoids and is a more complex procedure performed by a colorectal or general surgeon.

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