Hemorrhoidal banding or band ligation is an outpatient procedure, and we primarily band internal hemorrhoids because of the innervation pattern for internal hemorrhoids versus external hemorrhoids. If you band an internal hemorrhoid, it's not exactly painful. However, if you ban an external hemorrhoid because the nerve supply to an external hemorrhoid is very similar to what you have in your skin, and so it'd be like pinching your skin to skin fell off. So that's why we don't generally band external hemorrhoids. Now, in the banding band gradually cuts through the ligated hemorrhoidal vein, and it will actually slough off or pass when you're having a bowel movement, generally within five days. Now, there may be a small ulceration or defect in the region. And so you may notice a little discomfort or even some blood streaking for a few days after the band has passed. However, this is generally a benign circumstance. And with good anal hygiene shouldn't be a problem.
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