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Hemorrhoidal bleeding in chronic spinal cord injury: results of multiple banding

B C Cosman1, D A Eastman, I Perkash

  • 1Spinal Cord Injury Service, Department of Veterans Affairs Medical Center, Palo Alto, California.

International Journal of Colorectal Disease
|January 1, 1994
PubMed

Insights

Hemorrhoidal bleeding is common in spinal cord injury (SCI). Banding procedures offer a safe and effective treatment, with most patients experiencing significant symptom reduction and finding the treatment worthwhile.

Area of Science:

  • Urology
  • Gastroenterology
  • Neurology

Background:

  • Hemorrhoidal bleeding is a prevalent issue among individuals with chronic spinal cord injury (SCI).
  • Standard treatments may be complicated by altered sensation and autonomic dysfunction in SCI patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of hemorrhoidal banding for managing bleeding in men with chronic SCI.
  • To assess patient-reported outcomes following the banding procedure.

Main Methods:

  • Eighty-seven hemorrhoidal banding procedures were performed on 62 men with chronic SCI.
  • Banding targeted sites at or distal to the dentate line, often requiring multiple bands per session.
  • Patient outcomes were assessed via questionnaire at a mean follow-up of one year.

Main Results:

  • No major complications were reported during or after the banding procedures.
  • Of the 60 subjects who completed the questionnaire (97% response rate), 73% reported significant bleeding reduction, and 20% reported some reduction.
  • A majority of patients considered the procedure useful or worthwhile.

Conclusions:

  • Hemorrhoidal banding is a safe and effective treatment for managing hemorrhoidal bleeding in patients with SCI.
  • The procedure can be performed despite absent sensation, though autonomic hyper-reflexia is a consideration for high-level SCI.
  • Multiple banding sessions are often necessary but well-tolerated.

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