About 10 million Americans suffer from hemorrhoids, which are veins in the rectum and anus that swell and can itch and bleed. Some hemorrhoids get small blood clots (thromboses) and these are exquisitely painful.

Banding of hemorrhoids (ligation) is an office procedure where internal hemorrhoids are tied off at the base, cutting off the blood supply to the vessel. The hemorrhoid falls off over time and scar tissue prevents its re-formation.

The main downside is pain, but patients can usually be treated with mild pain relievers and warm baths to soothe the area. Bleeding may occur until the healing is complete and patients are asked to avoid aspirin or other blood thinners before and during the procedure.

Side effects are rare and in the majority of patients the hemorrhoids are eliminated with this method. About 1 out of 10 patients will need surgery to deal with the problem if banding does not work.