Post-Band Ligation Bleeding: When to Seek Medical Advice?

Post-banding bleeding of internal hemorrhoids?

Hello Doctor: I underwent a rubber band ligation for internal hemorrhoids on November 1 (Friday).
As of now, November 18 (Monday), I have experienced slight bleeding during bowel movements.
The bleeding has not been severe since the surgery, and there is no pain; there are only small blood spots or stains on the surface of the stool.
I do not feel any discomfort during bowel movements and feel that I have returned to normal.
However, I have read that bleeding should only last one to two weeks.
Since I have been quite busy with work, I plan to return for a follow-up at the end of the month.
I would like to ask if it is necessary to schedule an earlier follow-up appointment.
Thank you.

Niming, 20~29 year old female. Ask Date: 2019/11/18

Dr. Ke Fangxu reply Surgery

Mild bleeding after hemorrhoid ligation is a normal occurrence.
If there is no significant discomfort or heavy bleeding, there is no need to return for an earlier follow-up appointment.

Reply Date: 2019/11/18

More Info

After undergoing a rubber band ligation for internal hemorrhoids, it is not uncommon to experience some bleeding during bowel movements. This procedure is designed to cut off the blood supply to the hemorrhoid, causing it to shrink and eventually fall off. Post-operative bleeding can occur as part of the healing process, especially in the first couple of weeks following the procedure.
In your case, you mentioned that you have been experiencing slight bleeding since the procedure on November 1, and that the blood is only on the surface of the stool, without any associated pain or discomfort. This is generally a reassuring sign, as it indicates that the bleeding is likely minor and not indicative of a serious complication. However, it is important to monitor the situation closely.

According to medical guidelines, while some bleeding can be expected for up to two weeks post-procedure, if the bleeding persists beyond this timeframe or if it increases in volume, it is advisable to seek medical attention sooner rather than later. Additionally, if you experience any new symptoms such as significant pain, changes in bowel habits, or signs of infection (such as fever or increased swelling), you should contact your healthcare provider immediately.

Given that you are currently experiencing mild bleeding without discomfort, it may not be necessary to rush to the clinic. However, it is essential to remain vigilant. If the bleeding continues beyond the two-week mark or if you notice any changes in the nature of the bleeding, it would be prudent to schedule an earlier appointment.
In the meantime, ensure you are maintaining a high-fiber diet and staying well-hydrated to facilitate smooth bowel movements, which can help minimize strain and further irritation to the surgical site. Over-the-counter stool softeners may also be beneficial if you find that you are experiencing any difficulty with bowel movements.

In summary, while your current symptoms may not warrant immediate concern, it is crucial to keep an eye on the situation. If you have any doubts or if your symptoms change, do not hesitate to reach out to your healthcare provider for advice. Your health and peace of mind are paramount, and it is always better to err on the side of caution when it comes to post-operative care.

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