Post-Hemorrhoid Ligation: Bleeding and Concerns

Post-operative bleeding after hemorrhoid ligation?

Hello Dr.
Ke,
I have been experiencing blood in my stool for at least ten years.
Four to eight years ago, three colorectal specialists diagnosed me with internal hemorrhoids.
The last time I noticed blood in my stool was seven months ago.
Recently, on June 21, I underwent a ligation procedure for internal hemorrhoids at National Taiwan University Hospital's Hsinchu branch.
1.
After the ligation, I have been experiencing blood in my stool daily for the past three days, up until June 24.
Is this normal?
2.
Additionally, I have been using a topical ointment for the internal hemorrhoids, and I have been injecting a considerable amount.
Could this be mixing with the blood from the ligation site, resulting in darker red clots in my stool? Generally, the color of my stool is normal yellow, and the consistency is also normal; this clot only constitutes a small portion.
I am very concerned and would greatly appreciate your assistance! Thank you very much.

Mr. Yang, 50~59 year old female. Ask Date: 2018/06/24

Dr. Ke Fangxu reply Surgery

1.
A small amount of bleeding from the wound after hemorrhoid ligation is normal; as long as there is no significant bleeding, it is not a concern.

2.
It is generally not recommended to insert ointments or suppositories into the anus immediately after ligation, and it is best to refrain from using them to avoid affecting wound healing.
It is also normal for the ointment to mix with the bleeding.

Reply Date: 2018/06/24

More Info

After undergoing hemorrhoid ligation, experiencing some bleeding is not uncommon, but it is essential to understand the nature and extent of this bleeding to determine whether it is a cause for concern.
1. Post-Surgery Bleeding: Following a hemorrhoid ligation, it is typical for patients to notice some bleeding, especially in the first few days after the procedure. This bleeding can occur as a result of the surgical site healing and the ligation process itself. The ligation involves placing a rubber band around the base of the hemorrhoid, which cuts off its blood supply. As the hemorrhoid shrinks and eventually falls off, some bleeding may occur. However, if the bleeding is persistent, increasing in volume, or accompanied by severe pain, it may indicate a complication such as infection or improper healing.

2. Nature of the Blood: The blood you are observing in your stool could be mixed with the softening agents or ointments you are using for your internal hemorrhoids. If you are injecting a significant amount of ointment, it is possible that this could mix with the blood from the ligation site, leading to darker clots or streaks in your stool. The fact that your stool remains normal in color and consistency is a positive sign, but the presence of blood should still be monitored closely.

3. When to Seek Medical Attention: If the bleeding continues beyond a week, increases in volume, or if you experience symptoms such as dizziness, fainting, or severe abdominal pain, it is crucial to contact your healthcare provider immediately. These could be signs of a more serious issue that requires intervention.
4. Post-Operative Care: It is essential to follow your doctor's post-operative care instructions carefully. This may include dietary changes to ensure softer stools, the use of stool softeners, and avoiding straining during bowel movements. Keeping the area clean and dry is also vital to prevent infection.

5. Long-Term Considerations: If you have a history of rectal bleeding, it is essential to continue monitoring your symptoms and maintain regular follow-ups with your healthcare provider. They may recommend further evaluations, such as a colonoscopy, especially if bleeding persists or if there are changes in your bowel habits.

In summary, while some bleeding after hemorrhoid ligation can be normal, it is essential to monitor the situation closely. If you have any concerns or if the bleeding does not resolve, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your health and peace of mind are paramount, and addressing any issues promptly can help prevent complications.

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