Peninsula Gastroenterology Medical Group, Gastroenterologists logo for print
Peninsula Gastroenterology Medical Group, Gastroenterologists
Redwood City: 2900 Whipple Ave | Suite 245 |Redwood City, CA 94062 • Phone: 650-365-3700
Mountain View: 2495 Hospital Drive | Suite 600 | Mountain View, CA 94040 • Phone: 650-964-3636

Due to COVID-19 concerns, PGI is providing telemedicine services.
Telemedicine Telemedicine Help


Hemorrhoid Banding

At PGI, we use the patented CRH-O’Regan SystemTM, considered the “gold standard” treatment.  This highly effective, minimally invasive procedure is performed in our offices and at our Atherton Endoscopy Center. If there are multiple hemorrhoids, we treat them one at a time in separate visits.

During the brief and painless procedure, our gastroenterologist places a small rubber band around the tissue just above the internal hemorrhoid where there are few pain-sensitive nerve endings.  Unlike traditional banding techniques that use a metal-toothed clamp to grasp the tissue, we use a gentle suction device, reducing the risk of pain and bleeding.  Advanced cases where the diagnosis is both internal and external hemorrhoids may require additional therapy as rubber banding alone may not be suitable.

The banding procedure used by us works by cutting off the blood supply to the hemorrhoid.  This causes the hemorrhoid to shrink and fall off, typically within a day or so.  You probably won’t even notice when this happens or be able to spot the rubber band in the toilet.  Once the hemorrhoid is gone, the wound usually heals in a week or two.

During the first 24 hours, some patients may experience a feeling of fullness or a dull ache in the rectum.  This can typically be relieved with an over-the-counter pain medication.  However, most patients treated with the CRH-O’Regan SystemTM have no post-procedure pain. 

For one, the instruments used are smaller, affording greater comfort for patients and better visibility for physicians.  Unlike other devices, they are single use and 100% disposable. 

In most cases, banding can take place during your first appointment. The first appointment will consist of, at minimum, a consultation with a board-certified gastroenterologist. If the diagnosis is hemorrhoids, treatment can start immediately.  In the event of multiple hemorrhoids, often the largest, most symptomatic hemorrhoid is banded first.  Additional appointments are then scheduled to treat the remaining hemorrhoids at one to two week intervals with a final check-up three weeks later. 

After Care

Following hemorrhoid banding, we recommend that you rest at home for the remainder of the day and resume full activity the next day.  You can have normal bowel movements during this time, but you may want to soak in a sitz bath (a warm tub with a tablespoon of table salt added).

Soon you’ll be feeling much better, but you’ll need to make some changes to prevent future problems.  Straining due to constipation should be carefully avoided, so be sure to drink seven or eight glasses of water (around 50 ounces) a day and add two tablespoons of natural oat or wheat bran to your diet.  (Metamucil, Benefiber, flax or other soluble fiber may be helpful as well.)

The Center for Colorectal Health also recommends that you not sit longer than two minutes on the toilet.  If you can’t have a bowel movement in that time, come back later.  This two-minute rule can help keep you from straining during bowel movements without realizing it.  Finally, when traveling by air, stay hydrated, avoid alcohol, eat fiber and walk around when you can.

Hemorrhoid Treatment Comparison

The Should be CRH O’Regan SystemTM is appropriate for an estimated 90% of hemorrhoid patients.  Only the most severe cases require surgery (hemorroidectomy), which is just one more reason not to delay treatment. If you wait too long—and your hemorrhoids grow too large—your non-surgical options decrease.

The chief complaint about conventional rubber banding—which demonstrates superior long-term efficacy over other non-surgical methods—has been pain in 4-29% of cases.  In contrast, only 0.2% of patients treated with our advanced technique experience post-procedure pain.  Our method is also faster, more accurate and has virtually no downtime. 

Over the years, a number of new treatments have been devised for hemorrhoids, but none has outperformed the CRH-O’Regan System.  Among them are infrared photocoagulation, or the use of lasers to burn the hemorrhoid tissue, and stapled hemorroidectomy, a surgical variation that uses a circular stapler device to lift and remove the hemorrhoid. 

Average Procedure Time
Average Time Off Work
Pain Medication Required Pre/Post
CRH-O'Regan SystemTM
30 seconds – 1 minute
0-1 day
Conventional Rubber Banding
5-10 minutes
0-3 days
Often Prescribed
Infrared Coagulation (IRC)
30 seconds - 3 minutes
0-1 day
Stapled Hemorrhoidectomy
15-90 minutes
1-10 days
Conventional Hemorrhoidectomy
45-90 minutes
10-14 days

This information was taken from The Center for Colorectal Health. For more information about the CRH O’Regan SystemTM please visit



Related Links

Atherton Endoscopy Center photo

Atherton Endoscopy Center

While you are a patient at Atherton Endoscopy Center, our highly competent and professional staff will care for you. Everyone from the receptionist to the physician embraces our philosophy of patient-focused care. Above all, our staff is friendly and concerned for your comfort.