The Band Ligation Procedure

Rubber band ball

If you read my post from a few weeks ago, you already know that I have three hemorrhoids inside my butt. Yep. Three. What can I say? I’m an overachiever.

Why am I writing about hemorrhoids on my Endometriosis blog? Well, that’s because any one of you (yes, even you), can get them. Especially if you’re having to fight constipation, diarrhea, or both. And what do a lot of us with Endo have? Pooper-problems: yep. Constipation and diarrhea.

Today was the big day to remove the first of the three: the band ligation. Was I nervous? Of course. I didn’t truly know what to expect other than a tiny rubber band would be going around my lumpy li’l hemorrhoid. I already verified with my surgeon’s office that the band didn’t have any latex (I have an allergy), so that was a relief. Google didn’t help answer my “is it gonna hurt afterward” inquiries. I envisioned myself squirming for days, sitting on a donut pillow, walking like I had just ridden in a rodeo.

Am I? Nope!

SO I wanted to share my experience, in case any of you were ever diagnosed with internal hemorrhoids and needed to undergo band ligation. But, realize that every person is different…and this is my experience.

Once in the exam room, the nurse took my blood pressure and laughed at my lame jokes. Then, I was asked to strip from the waist down and to drape the paper blanket over my lap. He left and gave me the privacy to shed my pants and skivvies, I took a precursory look at the small tray of tools and blob of lube, and hopped onto the exam table.

I was literally in and out of that office in 20 minutes: start to finish. The actual procedure took less than five minutes!

Dr. Matthew Schulztel arrived with big smiles and a warm handshake and it was time!

I was worried there’d be some type of numbing injection. Nope. Nothing but the calm, soothing voice of my colo-rectal surgeon warning me of sensations I may experience as tools went in and out.

Did it feel good? Nope. Was it painful? Nope. But it was uncomfortable…mostly just awkward. The doc lubed me up real well first, then a big metal tube went into my butt (I presumed to hold it wide open). Once my body acclimated to the intrusion, it wasn’t too uncomfortable. Then he inserted the little metal rod device that had the rubber band on it. I could feel it as the tool bumped around inside my poopchute, and could feel an odd sensation as the hollow-tube that housed the band surrounded my hemorrhoid. “You’re gonna feel a pinch,” he warned. And yep, just a slight pinch as the band was placed at the base of my ‘rrhoid. A few deep breaths, the tools were removed, and all was back to normal.

As I laid there on my side, knees together up to my chest, all I could think of while he was inside was how oddly similar this felt to a pap smear; just in a different hole. It really wasn’t as awful as my brain thought it was going to be!

I go in on August 28th for my second hemorrhoid to be similarly attacked.

He did warn that I may feel like I have to poop because of the weird band around my ‘rrhoid; at least until it fell off in one to four days, he even thought it may just fall off today! As I got dressed, I marveled on how I couldn’t feel anything. I even sat down on the chair (gingerly, at first) to put my boots on. I didn’t feel a darn thing!

But as I walked toward my car in the parking lot, I felt exactly what he was talking about. And the car ride back to work. And even now as I type this up for you. An unmistakable urge to just go void my bowels. I’m glad he gave me the head’s up. Have I tried to poo yet? Nah. I’m just gonna nurse this li’l feeling for a while.

Curious about the tools used? Let’s see what Dr. Google shows us. There are lots and lots of brands of tools, and I’m clueless what he used, but here’s a general idea:

hemorrhoid bands for ligation
The band: these teeny, tiny black bands are what get the job done! Once secured around the base of the hemorrhoid, the blood supply is cut off and the little ‘rrhoid dries up and falls off. Alibaba, lucid O bands
Anoscope
The butthole opener tube: I’ve learned it’s called the anoscope or proctoscope. It’s hollow once you pull that handle-portion out. It totally keeps things open and unencumbered for the physician to do his business. Courtesy of Henry Schein Medical, Item No. 4268469
band ligator cone
The band-spreader thingy: the rubber band goes on the tiny tip of this little metal cone, then gets slid up and loaded onto the next tool. And the cone goes away now; it’s job is done. Photo courtesy of Medline, Item No. MDS6840410
The band delivery device: the band goes around the hollow round tip (the cone doesn’t remain attached once the band is around the round tip). That hollow tubed-tip slides inside the anoscope, into the poopchute, over the ‘rrhoid and, once in position, the plunger gets pressed and the rubber band slides into place around the base of the hemorrhoid. Medline, Item No. SKA801910

And, of course, luuuuuuuuuuuuube!

If you’re going to have your own internal hemorrhoid ligation, I hope this eased some fears for ya and answered some questions. I’m all set to go in and do this again in another month!

Bye bye hemorrhoids!!!

~ Again, I am a layman. I do not hold any college degrees, nor mastery of knowledge. Please take what I say with a grain of salt. If curious, do your own research. Validate my writings. Or challenge them. And ALWAYS feel free to consult with your physician. Always. Yours ~ Lisa

Blood and Poop and Headlamps … OH MY!

Proctoscope, gloves, and a blob lube
That’s gonna go…where?!?

So, over the past two months, I’ve been experiencing some bleeding when I poo. I’ve taken several first aid and civilian medical classes, so I knew it wasn’t anything to worry about: the color and texture was well within the “don’t freak out” range.

I noted these incidents on my food & symptom journal and booked an appointment with my PCP to discuss and get a possible referral to my PoopChute doctor.

Although I blog about poo and guts and all kinds of other lovely and taboo things, going into the doctor’s office to actually have them examine my bunghole is not my idea of good time. It’s even more horrific than having to buy pads or tampons when there’s only male cashiers…although I finally grew out of that trauma in my 30s.

Butt, I mean but, sometimes you just have to go to a professional and have them stick their finger in your but, I mean butt.

After a lengthy discussion of my symptoms, my diet, my fiber and water intake, and (lack of) exercise, there was the dreaded visual inspection and internal exam. Nothing abnormal was seen or felt, and I received the referral to my colo-rectal surgeon with the suspicion of tiny hemorrhoids or a possible recurrent fissure. And my PCP, Lauren Campagna, is freakin’ amazing and always makes me feel at ease.

A few weeks later (aka this past Wednesday), I repeated the process with my colo-rectal surgeon, Dr. Matthew Schultzel. I feared I was wasting his time. He did major surgeries, like my bowel resection. And here I was asking him to examine my bleeding arse. He assured me that this was a huge part of his practice and that I wasn’t wasting his time.

We talked about my symptoms and diet, he examined my incisions and pushed on my guts to check on my post-op healing, and then we got down to the real nitty-gritty.

He slipped on a headlamp, I assumed the position, and it truly wasn’t as uncomfortable as I’d imagined. First was the finger exam, followed by the clear duck-bill lookin’ device that taunted me from the exam room table (I later learned it’s called a proctoscope!). Again, it wasn’t too uncomfortable. It was awkward, but there wasn’t any pain. And Dr. Schultzel’s constant reassurances and jokes made the awkwardness far less than it could have been.

Lo and behold, I’m an overachiever: I have three various-sized hemorrhoids inside my guts. THREE! And a tiny skin tag, likely the remnants of a prior hemorrhoid.

The plan? There’s an in-office technique known as band ligation.

“Like rubber bands on a pig’s balls?” I asked.

“Exactly,” he laughed, and said he usually reserves that example for his Texan patients. Score one for growin’ up in Arizona!

So, I go in on July 31st for the fist of my three banding procedures. He’ll be slipping a tiny rubber band around the base of one of my three stowaways..and in several days it will just fall off. I’ll bleed or spot for a bit. Then 4-6 weeks later, repeat the process. Then repeat it once more! BUT his office is currently checking on the latex-content of the bands since I have an allergy…hopefully there’s an alternative if one is needed.

I most certainly don’t strain when I poo. Everything just kind of falls out easily since my surgery. And I drink A LOT of water all day, as well as take a fiber supplement every morning. So why do I have hemorrhoids? And three?? He let me know that it’s not uncommon for the body to go through weird changes after a bowel resection. I’ll take that theory!

So if you ever find yourself poo’ing and finding blood on your toilet paper: please contact your doctor. There are MANY different causes for bloody stool. And it should never be taken lightly.

That being said: it’s poop. And poop is embarrassing. And nobody wants to talk about it. But, as a friend of mine said to put my mind at ease, “Remember that your doctor purposely spent years and years and many thousands of dollars for the honor of looking up your bunghole. Whatever happens, it’s his privilege to experience!” So, talk to your doctor!!

I’d love to hear about your experiences! Feel like giving me a little insight into your poopchute? Have you had fissures or hemorrhoids before? How’d it go? Do you use something like the Squatty Potty? Or what’s your favorite fiber or stools softener? Share with the class 🙂