Hemorrhoid BandingHemorrhoids are nothing to feel ashamed about because they are so commonplace. Ari Nowain, MD is a highly specialized and experienced gastroenterologist with a focus on the treatment of internal hemorrhoids. He owns and operates the Center for GI Health, a location in the heart of Beverly Hills that is dedicated to treating gastrointestinal problems. He has helped hundreds of patients in the greater Los Angeles area alleviate their hemorrhoid discomfort and pain with the help of hemorrhoid banding, or rubber band ligation treatment.

Hemorrhoid banding is fast, reliable, and painless and works for more than 95% of hemorrhoid patients. The procedure is performed within the office and is significantly cheaper than other alternatives. It’s important to consult an expert gastroenterologist like Dr. Nowain if you feel anal pain or discomfort because as a hemorrhoid grows, the number of non-surgical options decreases.

Hemorrhoid Band Ligation

Dr. Nowain utilizes the CRS O’Regan FDA Approved system of hemorrhoid banding procedure, otherwise known as rubber band ligation, to treat and remove internal hemorrhoids. This method allows him to gently suction the hemorrhoid in place and cut off its blood supply by placing a small rubber band around the base.  In a few days, the banded hemorrhoid spontaneously falls off without the patient ever noticing. The entire procedure is painless because it occurs above the dentate line (nerve line). Hemorrhoid ligation has an extremely low risk of complication, has a high rate of success, and induces very little pain/discomfort. Watch the below hemorrhoid banding video to get a better idea of this procedure.


Hemorrhoids are extremely common, so much so that they affect half of the population at some point in their life. Hemorrhoids are swollen veins in the lower rectum or anus that can be caused by dehydration, prolonged sitting, diarrhea or constipation.

There are two different types of hemorrhoids: internal hemorrhoids and external hemorrhoids.  Physical examinations are necessary in order to determine which type a patient has.

How To Eliminate Hemorrhoids

Dr. Nowain must first assess the type of hemorrhoid before being able to conduct the correct treatment. In general, the first step in every case is to accurately diagnose the problem, then cover various treatment options with the patient, and finally perform the agreed upon treatment.

There are a number of treatment options depending on the type of hemorrhoid a patient has (internal versus external).  Rubber Band Ligation is Dr. Nowain’s preferred method of treatment when dealing with internal hemorrhoids because it is surgery free, has a short recovery time, and the patient experiences minimal, if any, pain.  External hemorrhoids are treated with medication or surgeries and cannot be treated with rubber band ligation.

Is Hemorrhoid Banding Safe?

Safety is always Dr. Nowain’s primary concern. Luckily, rubber band ligation is an extremely safe procedure with a very high level of success and a low level of reoccurrence. As long as the pre-op and post-op instructions are observed there’s almost no likelihood of something going wrong. A few additional reasons why the procedure is so safe is because:

  • The instruments are smaller, making the procedure more comfortable
  • The instruments used by Dr. Nowain are single use and 100% disposable, decreasing the risk of contamination and infection. He avoids the use of older, traditional banding techniques, which use metal-toothed clamps and increase the risk of pain and bleeding.
  • Anesthesia is unnecessary.

Does Hemorrhoid Banding Work Better Than Over The Counter Medicine?

Many patients first try over the counter ointments and creams like Preparation H to try and treat hemorrhoids. Although temporary relief may be found with much smaller cases, these types of medications don’t address the underlying problem, resulting in reoccurring cases of hemorrhoids. Ultimately, those creams and medications only address the symptoms, not the hemorrhoids themselves. It isn’t until the underlying problems are addressed that this never-ending cycle will end. Fortunately, the CRH O’Reagan system that Dr. Nowain employs gets at the root of the problem, severely cutting down the likelihood of reoccurrence.

Unlike other methods of hemorrhoid treatment, less than 1 % of patients that undergo hemorrhoid banding experience substantial pain or bleeding after the procedure. That’s significantly less than the 4-29% with other hemorrhoidal banding techniques. It’s also considerably faster, taking less than one-and-a-half minutes for the entire procedure to be completed.

The CRH O’Regan Procedure

There are a number of types of hemorrhoid banding, but they are usually very expensive, more painful, and they have increased chances of significant bleeding. As opposed to other methods, the CRH O’Regan System uses a disposable suction tool called a ligator to suction and hold the hemorrhoid in place. A rubber band is then slipped down the ligator and onto the base of hemorrhoid. This cuts the blood flow into the hemorrhoid, resulting in complete removal in an easy and comfortable way. Internal hemorrhoids are painless because they are above a group of nerves called the dentate line and anything that’s above it generally cannot be felt.

Why Hemorrhoid Banding

Hemorrhoid banding is one of the best and safest procedures on the market for treating internal hemorrhoids for multiple reasons. Dr. Nowain’s method utilizes smaller instruments, making the procedure far more comfortable than comparable procedures. Patients do not have to go under anesthesia and the instruments are completely disposable, decreasing the risk of infection/contamination.  In order to avoid complications are completed one at a time in two week intervals. On average, bandings three separate sessions

It’s important to note that banding ligation cannot be performed on pregnant women. During pregnancy, Dr. Nowain will treat hemorrhoids with temporary stopgap measures like creams. However, after pregnancy banding ligation is possible.  This is one of the reasons why it’s particularly important for women in particular to see Dr. Nowain prior to conceiving.

To summarize:

  • Hemorrhoid banding is faster, cheaper, and less painful in comparison to other alternatives
  • The procedure is performed in an office setting
  • Hemorrhoid band ligation doesn’t take more than a few minutes to complete
  • Recovery time is usually between 2 and 3 days after the procedure.

Is Hemorrhoid Banding Covered by Insurance?

Hemorrhoid banding is coverable by both PPO and Medicare.  Additionally, reasonable prices are available to patients who lack medical insurance.

Make Your Appointment With Dr. Nowain

It’s important to talk with Dr. Nowain to find out about all of your non-surgical options. Dr. Ari Nowain is one of the best Los Angeles GI doctors who treats hemorrhoids and other related conditions. However, if you are suffering from hemorrhoids and are looking to permanently remove them in Los Angeles, contact the Center for GI Health at (310) 657-4444.

I think we should include in this section the concept of how many bandings are needed (i.e average of three sessions at two week intervals ) and explain why. I think we should also emphasize that this is much cheaper than other methods and is performed in the office setting. Minimal recovery times should also be discussed. Bullet points to summarize these points maybe beneficial.

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