At Gastroenterology Associates of Southeastern
Virginia, we use the patented, CRH O’Regan System™, considered
the “gold standard” treatment. This highly effective (99.1%),
minimally invasive procedure is performed in our offices in less than
a minute. If there are multiple hemorrhoids, we treat them one at
a time in separate visits.
During the brief and painless procedure, our
physician specialist places a small rubber band around the tissue
just above the hemorrhoid where there are few pain-sensitive nerve
endings. Unlike traditional banding techniques that use a metal-toothed
clamp to grasp the tissue, we use a gentle suction device, reducing
the risk of pain and bleeding.
Our banding procedure works by cutting off
the blood supply to the hemorrhoid. This causes the hemorrhoid to
shrink and fall off, typically within a day or so. You probably
won’t even notice when this happens or be able to spot the
rubber band in the toilet. Once the hemorrhoid is gone, the wound
usually heals in a week or two.
During the first 24 hours, some patients may
experience a feeling of fullness or a dull ache in the rectum. This
can typically be relieved with an over-the-counter pain medication.
A remarkable 99.8% of patients treated with our method have no post-procedure
pain, however. Any pain should be reported to your physician as
soon as it is noticed.
In fact, thanks to design improvements,
our procedure has a ten-fold reduction in complications compared
to traditional banding.
For one, our instruments are smaller, affording
greater comfort for patients and better visibility for physicians.
Unlike other devices, they are also single use and 100% disposable.
Following hemorrhoid banding, we recommend
that you rest at home for the remainder of the day and 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 with
a tablespoon of table salt added) or use to a bidet for a gentler
cleansing of the anal opening.
Soon you’ll be feeling much better,
but you’ll need to make some changes to prevent future problems.
Straining due to constipation should be diligently avoided, so be
sure to drink seven or eight glasses of water (around 50 ounces)
a day and add two tablespoons of natural oat or wheat bran to your
diet. (Metamucil, Benefiber, flax or other soluble fiber may be
helpful as well.)
We also recommend that you not sit longer
than two minutes on the toilet. If you can’t have a bowel
movement in that time, come back later. This two-minute rule can
help keep you from straining during bowel movements without realizing
it. Finally, when traveling by air, stay hydrated, avoid alcohol,
eat fiber and walk around when you can.
FREQUENTLY ASKED QUESTIONS
1. What are hemorrhoids?
Hemorrhoids are swollen veins located in the lower rectum or anus.
There are two types of hemorrhoids: internal and external. Depending
on the location, symptoms may include pain, inflammation, itching,
and a feeling of fullness following a bowel movement. Additionally,
there may be bright red blood covering the stool, on the toilet
tissue or in the toilet bowl.
2. What causes hemorrhoids?
Hemorrhoids result from an increase in pressure in the veins of
the rectum. This may be caused by constipation, pregnancy, childbirth,
obesity, heavy lifting, long periods of sitting, or diarrhea. In
Western countries, constipation is associated with diets low in
fiber and high in fat.
3. Who gets hemorrhoids?
Hemorrhoids affect both men and women. The incidence of hemorrhoids
increases after age 30, and by age 50, about half of the population
will have experienced the condition.
4. How does the procedure work?
A small disposable syringe like device is used to attach a tiny
rubber band around the internal hemorrhoid – with the blood
supply cut off, the hemorrhoid dies and falls off.
5. Can you treat external hemorrhoids?
Yes. Most hemorrhoidal symptoms are from dilated internal hemorrhoids
and/or anal fissures. The banding of internal hemorrhoids usually
shrinks the external hemorrhoids as well and is highly effective
in relieving the symptoms of pain and bleeding. After banding is
completed there may be an external component or skin tag that persists,
but usually they do not cause much in the way of symptoms.
6. How many bands are necessary?
There are three sites where hemorrhoids form frequently, and it
is not uncommon for all three sites to require treatment. We generally
only band one hemorrhoid site at a time in separate visits, as multiple
bandings have been found to increase complications. Also, some extreme
large hemorrhoids may require additional banding sessions. Thus,
as many as six bands total may be used in severe cases, but one
to three is standard
7. Is it effective?
Yes it is 99.1% effective, and the best thing is that it is non-surgical,
so there is no pain, medication or recovery time needed. Most of
our patients go back to work the same or next day.
8. How long will this take?
The procedure takes about 60 seconds, but the entire visit is about
9. Is the procedure covered by Insurance?
Although insurance coverage varies, the procedure is covered by
most insurance plans, including Medicare.
10. Will it hurt?
No. Thanks to our improved instrument and technique, band placement
is painless. You may experience a feeling of fullness or dull ache
in the rectum for the first 24 hours, but this can generally be
relieved by over-the-counter pain medication. A recent study of
our banding technique shows that 99.8% of patients experience no
11. Will I have to miss work or other
Your first appointment in our office will probably be the longest,
as it involves a consultation, medical history and diagnosis. We
suggest you allot up to an hour. Subsequent treatment sessions will
be shorter, around 15-30 minutes total. After a hemorrhoid banding
procedure, we recommend that you rest the remainder of the day at
home and resume full activity the next day. However, many patients
with office jobs find they can return to work immediately following
12. Will I need to do any preparation
at home prior to the procedure?
No prep is needed prior to the procedure.
13. Will I need a driver or can I
drive home myself?
You will not need a driver, in fact most patients return to normal
activity immediately following the procedure.
14. Will the hemorrhoids come back
after the treatment?
With proper dietary changes the hemorrhoids should not return.
For more information about the CRH
O’Regan System™ please visit www.crhsystem.com