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Julio Alejandro Murra-Saca MD.
Gastroenterologist, Coloproctologist
Tel : (503) 2226-3131, (503) 2225-3087, Celular (503)7887-2507
Edificio Centro Scan, Colonia Médica, San Salvador, El Salvador.


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Notes on Cyber Gastroenterology


Modern hemorrhoids treatment with rubber bands

The use of rubber bands in the therapy of hemorrhoids is currently the most widely accepted form of treatment for this ailment, due to its low cost, practicality and effectiveness. In this form of treatment, which is performed on an outpatient basis here in our office, and which does not require anesthesia, special rubber bands are applied to the hemorrhoids after bringing the patient into a special position (see image), With this procedure only a minor discomfort is felt by the patient in the form of a mild pinching sensation during the application of the bands, which is well tolerated by just about all patients.

Rubber band ligation — Rubber band ligation is the most widely used technique for treatment of symptomatic internal hemorrhoids that are refractory to conservative treatment. This procedure has been available since the early 1960s and is effective, inexpensive, requires no anesthesia, is easy to perform, and only rarely causes serious complications. The technique may be used for first, second, and selected third degree hemorrhoids. Successful ligation results in thrombosis of the hemorrhoid, and the development of localized submucosal scarring.




Position for Rectal Digital Examination




See following sequential images and video-clips

Please click on image to download the video clip. Please click on image to download the video clip.

Prolapsed grade 3 internal hemorrhoid is seen with signs of congestion and ulceration.
Image as is seen with the video colonoscope.

See the sequence of rubber band treatment for hemorrhoids

The next images and video clip are the sequence of evolution of the treatment
with rubber bands


Please click on image to download the video clip.

Please click on the image to download the video clip.

Recently ligated hemorrhoid in which the strangling effect of the rubber bands which eventually leads to necrosis (drying out) of the hemorrhoid is observed. This effect is similar to the drying out of the ligated umbilical chord in the newborn.

Hemorrhoid 6 hours after application of rubber bands. Note the purple discoloration.

For more endoscopic details please click on the image  to download the video

Hemorrhoid 48 hours after application of rubber bands. A whitish coloration is seen.

For more endoscopic details please download the video clip by clicking on the image

Normally, after 2 to 7 days the hemorrhoid has fallen off and the rubber bands will follow soon, leaving only a small ulceration that heals promptly by itself without any complication.

As can be seen the treatment of hemorrhoids with rubber bands is a simple and effective method of curing this ailment. A normal patient is cured after an average of four weekly treatments on an outpatient basis. Patients that are on a tight schedule can receive these treatment sessions at 2 to 3 day intervals.

(See Proctology section for more information on hemorrhoids as well as other important rectal diseases)

"He thought to have hemorrhoids but turned out to have rectal cancer". Its important to point out that a number of patients have treated themselves with self-prescribed anti hemorrhoidal ointments or suppositories, only to have a rectal carcinoma detected on a later rectal digital examination.

For more information about Ano -Rectal diseases see Proctology



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