Post-Procedure Discomfort After Hemorrhoid Ligation

Internal hemorrhoid ligation

Hello, Dr.
Ke.
I apologize for the lengthy message.
I have four internal hemorrhoids that do not bleed or protrude.
Initially, I felt a foreign body sensation while walking, and there was a prickling discomfort near the anus.
On April 26th, Wednesday, the doctor performed a ligation on two of the internal hemorrhoids.
After a week, my condition improved, and I only experienced occasional mild itching.
On May 3rd, Wednesday, I returned for a follow-up (the doctor asked me to come back).
He only performed infrared coagulation on the other two hemorrhoids.
He did not mention anything specific about the two that were previously ligated, but I told him that some areas around my anus were a bit red and felt like eczema.
He also prescribed medication for me to apply.

Today, May 10th, while walking, the foreign body sensation feels somewhat different than before.
It feels slippery around the anus, almost like hair rubbing against hair, creating a slight foreign body sensation.
When I squat, there is a very mild prickling sensation, especially when I sweat a lot, which makes it feel worse.
Sometimes the prickling can be a bit painful, but it’s not very sharp or intense—just uncomfortable.
Previously, I felt like there was something inside when my anus contracted, but now there is no such feeling; it’s just a fuzzy sensation (for example, when standing or sitting and swaying my hips, it feels like something is bothering the area near the anus).
Why is this happening? Because during my last visit, the doctor told me I was graduated, and that everything would be fine after this procedure.
Could this be due to the healing of the wounds? Are there any uncomfortable symptoms that can occur during the ligation and infrared coagulation process?

A Cheng, 20~29 year old female. Ask Date: 2017/05/10

Dr. Ke Fangxu reply Surgery

Frequent anal treatments may lead to abnormal sensations, and due to the uncertainty regarding the interval between infrared therapy and ligation, we can only make this assumption.
In such cases, it is advisable to refrain from any further procedures and instead perform warm sitz baths while waiting for the anal wound to heal.
It is also recommended to consult a physician for medication to alleviate discomfort and other symptoms before determining the next steps for treatment.

Reply Date: 2017/05/10

More Info

After undergoing hemorrhoid ligation, it's not uncommon for patients to experience a range of discomforts as part of the healing process. The symptoms you describe, including a sensation of pressure or foreign body feeling in the anal area, mild itching, and occasional sharp sensations, can be attributed to several factors related to the procedure and the healing of the tissue.

Understanding Post-Procedure Discomfort
1. Healing Process: After hemorrhoid ligation, the body initiates a healing response. This involves inflammation and tissue repair, which can lead to sensations of discomfort, including itching and a feeling of fullness or pressure. The ligation itself causes the hemorrhoids to shrink and eventually fall off, which can create temporary irritation in the surrounding tissue.

2. Nerve Sensitivity: The anal region is rich in nerve endings, and any surgical intervention can heighten sensitivity. As the area heals, you may experience sensations that feel unusual, such as the "slippery" feeling you mentioned. This is likely due to the healing tissues and the adjustment of the surrounding skin and muscle.

3. Skin Irritation: The redness and irritation you noted could be a result of friction, moisture, or even a mild dermatitis. If you are experiencing increased sweating, this can exacerbate the irritation, leading to discomfort. It's essential to keep the area clean and dry to minimize these symptoms.

4. Post-Procedure Expectations: After ligation, it is typical for patients to experience some discomfort for a few weeks. This can include mild pain, itching, and changes in sensation. The fact that your symptoms have improved since the procedure is a positive sign, indicating that your body is healing.

Recommendations for Management
1. Follow-Up Care: Continue to follow up with your healthcare provider as recommended. If you notice any worsening symptoms, such as increased pain, significant bleeding, or signs of infection (like pus or fever), seek medical attention promptly.

2. Topical Treatments: Use any topical medications prescribed by your doctor to help with itching and irritation. Over-the-counter creams designed for anal discomfort may also provide relief.

3. Hygiene Practices: Maintain good hygiene by gently cleaning the area after bowel movements. Consider using moist wipes instead of toilet paper to reduce irritation.
4. Dietary Adjustments: Ensure you are consuming a high-fiber diet to prevent constipation, which can strain the anal area and exacerbate discomfort. Staying hydrated is also crucial.

5. Activity Modifications: If certain movements or activities exacerbate your discomfort, consider modifying them until you feel more comfortable. Avoid prolonged sitting or standing, and take breaks to relieve pressure on the anal area.

6. Pain Management: Over-the-counter pain relievers can help manage any discomfort you may experience. Always consult with your healthcare provider before starting any new medication.

Conclusion
The sensations you are experiencing post-hemorrhoid ligation are likely part of the normal healing process. While it can be uncomfortable, many patients find that their symptoms gradually improve over time. If you have any concerns about your recovery or if your symptoms persist or worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. They can provide personalized recommendations based on your specific situation and ensure that your recovery continues on the right track.

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