Post-Hemorrhoid Banding: Persistent Discomfort and Blood Concerns

Ten days after the ligation of internal hemorrhoids, there is still a slight sensation of skin irritation in the anal area, and occasionally there is a small amount of blood on the toilet paper after wiping?

I would like to ask the doctor, after completing three sessions of rubber band ligation for my internal hemorrhoids, I have been wiping gently, but I still feel a stinging sensation at the anal opening as if the skin is broken.
Could this be related to the ointment? The hospital prescribed "Hiyu Zhi" ointment, but I am concerned that prolonged use may thin the skin, so I only used it for 2-3 days and stopped.
I only apply it when there is bleeding, and I apply it with my fingers internally.
If I continue to feel this stinging sensation, should I return to the hospital for a follow-up, or is there another ointment that won't thin the skin that could help?

Niming, 20~29 year old female. Ask Date: 2019/01/17

Dr. Ke Fangxu reply Surgery

If the location of the hemorrhoid ligation is closer to the anal opening, there may be some sharp pain.
It is advisable to take warm sitz baths and wait for the wound to heal.
If there is no significant discomfort, there is no need to use ointments.
If there is concern about skin thinning, a simple petroleum jelly ointment can be used.

Reply Date: 2019/01/17

More Info

After undergoing hemorrhoid banding, it's not uncommon to experience some discomfort and even minor bleeding. The sensation of a "broken skin" feeling around the anal area can be attributed to several factors, including the healing process after the procedure, the use of topical medications, and the sensitivity of the skin in that region.

Firstly, hemorrhoid banding is a minimally invasive procedure that involves placing a rubber band around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and eventually fall off. While this procedure is effective for treating hemorrhoids, it can lead to temporary discomfort, especially during the healing phase. The sensation you're describing could be a result of irritation or inflammation of the skin around the anus, which is sensitive and can easily become aggravated.

Regarding the topical medication you mentioned, "喜癒痔" (which I assume is a topical ointment for hemorrhoids), it is important to follow the instructions provided by your healthcare provider. Overuse of topical steroids or certain ointments can indeed lead to skin thinning, especially if used excessively or for prolonged periods. If you are concerned about the potential for skin thinning, it is wise to limit the use of such medications to when they are absolutely necessary, as you have been doing.

If you continue to experience persistent discomfort, a "broken skin" sensation, or bleeding, it is advisable to return to your healthcare provider for a follow-up appointment. They can assess the healing process and determine if there are any underlying issues that need to be addressed. It’s also important to rule out any complications such as infection or the development of new hemorrhoids.

In terms of alternative treatments or medications that may help alleviate your symptoms without the risk of skin thinning, consider discussing the following options with your doctor:
1. Sitz Baths: Soaking in warm water for 10-15 minutes several times a day can help soothe the area and promote healing.

2. Witch Hazel: This natural astringent can be applied to the affected area to reduce irritation and inflammation.

3. Non-steroidal Anti-inflammatory Drugs (NSAIDs): Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage discomfort.

4. Fiber Supplements: Ensuring you have a high-fiber diet or taking fiber supplements can help prevent constipation, which can exacerbate hemorrhoid symptoms.

5. Gentle Cleansing: Instead of wiping, consider using moist wipes or a bidet to clean the area after bowel movements, which can reduce irritation.

6. Topical Anesthetics: Some over-the-counter creams may provide temporary relief from discomfort without the risk of skin thinning.

In conclusion, while some discomfort and minor bleeding can be expected after hemorrhoid banding, persistent symptoms warrant further evaluation. It’s crucial to communicate openly with your healthcare provider about your concerns and symptoms. They can provide tailored advice and treatment options to ensure a smooth recovery and address any complications that may arise. Your health and comfort are paramount, so don’t hesitate to seek further medical advice if needed.

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