the First Stage of Rubber Band Ligation for Internal Hemorrhoids - Surgery

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Stage One of Rubber Band Ligation for Internal Hemorrhoids


Hello Doctor: I underwent rubber band ligation for internal hemorrhoids a week ago.
On the third day, I noticed a little bleeding when I had a bowel movement, and I still feel a lump in my rectum.
It seems to become more pronounced when I try to use the toilet.
After the bowel movement, I have to rinse with warm water for about five minutes for it to reduce in size.
Since this is my first time undergoing ligation for internal hemorrhoids, I expected the size to be smaller than before, but when I feel it with my hand, it still seems quite large.
It becomes more noticeable after using the restroom, and I need to soak it in warm water to alleviate the swelling.
Should I expect the effects to become more apparent after three ligation sessions?

A-Hong, 30~39 year old female. Ask Date: 2017/08/08

Dr. Ke Fangxu reply Surgery


Answer: Should I engage in anal intercourse or wipe? If you have recently undergone hemorrhoid ligation surgery, it is advisable to avoid anal intercourse for a short period.
If there is a little blood when wiping, it is a normal occurrence.
If the ligation is too close to the anal opening, it may cause a tight sensation.
Generally, if there is no severe bleeding or prolapse, frequent ligation is not recommended.

Reply Date: 2017/08/08

More Info


The experience you are describing following your rubber band ligation for internal hemorrhoids is not uncommon. Rubber band ligation is a minimally invasive procedure used to treat internal hemorrhoids by cutting off their blood supply, which eventually causes them to shrink and fall off. However, the recovery process can vary significantly from person to person, and it is essential to understand what to expect during this time.

Firstly, it is important to note that after the procedure, it is normal to experience some bleeding, especially in the first few days. This bleeding can occur as the ligated hemorrhoid begins to necrose and detach. The presence of a "lump" or feeling of fullness in the rectal area is also common, as the tissue may still be swollen or inflamed post-procedure. The sensation of a lump can persist until the hemorrhoid has completely shrunk and resolved, which can take several days to weeks.

Regarding your concern about the size of the hemorrhoid, it is essential to understand that the ligation process does not provide immediate results. The hemorrhoid may still feel large initially because the tissue has not yet undergone the necrosis process. As the ligation takes effect, you should expect the hemorrhoid to gradually decrease in size over time. It is also worth noting that multiple ligation sessions may be required for optimal results, especially if you have larger or multiple hemorrhoids.

The use of warm water after bowel movements is a common practice to alleviate discomfort and promote relaxation of the anal sphincter. This can help reduce the feeling of pressure and swelling in the area. Additionally, maintaining good hygiene and using soothing topical treatments, such as witch hazel or over-the-counter hemorrhoid creams, can aid in your recovery.

If you continue to experience significant discomfort, persistent bleeding, or if the lump does not seem to decrease in size after a few weeks, it is crucial to follow up with your healthcare provider. They may want to assess the area to ensure that there are no complications, such as infection or retained tissue.

In summary, while it is normal to feel some discomfort and see some swelling after your first rubber band ligation, the hemorrhoid should gradually shrink over time. It may take a few weeks for the full effect to be noticeable, and multiple treatments may be necessary for complete resolution. Always consult with your doctor if you have concerns about your recovery or if your symptoms worsen. They can provide guidance tailored to your specific situation and ensure that you are on the right track to recovery.

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