Post-Surgery Bleeding After Hemorrhoid Ligation: When to Seek Help?

Bleeding after hemorrhoid ligation?

Hello Doctor: I have issues with internal hemorrhoids and anal fissures.
I underwent a hemorrhoid ligation procedure on November 11.
Although there was some minor bleeding afterward, it wasn't significant.
During my follow-up appointment on November 18, the doctor said my condition had improved a lot.
However, on November 23 and 24, I had hard stools and I'm concerned that I may have reopened the wound.
When I returned for a follow-up on November 25, I informed the doctor, but he said everything looked much better and there were no major issues.
He prescribed 14 suppositories, mentioning that there was some bleeding with the suppository.
However, after returning home, I still experienced bleeding during bowel movements, and it has been more than before.
Now, it's been three days of this.
Should I go for another consultation, or should I wait until I finish the suppositories prescribed by the doctor and then reassess the situation?

Liu Xiaojie, 20~29 year old female. Ask Date: 2019/11/27

Dr. Ke Fangxu reply Surgery

If the bleeding is not severe, using suppositories can be recommended.
During this period, it is advisable to avoid constipation and shorten the time spent on bowel movements.
Increasing dietary fiber intake can also be helpful.
Warm sitz baths should aid in alleviating symptoms.
However, if bleeding persists, it is best to consult a physician for evaluation.

Reply Date: 2019/11/27

More Info

After undergoing hemorrhoid ligation surgery, it is not uncommon for patients to experience some bleeding, especially if they are having difficulty with bowel movements. The fact that you had a small amount of bleeding initially and that your doctor noted improvement during your follow-up visit is a positive sign. However, the increase in bleeding after having hard stools raises some concerns that warrant further attention.

In general, after hemorrhoid surgery, patients are advised to monitor their symptoms closely. Here are some key points to consider regarding your situation:
1. Normal Post-Surgery Bleeding: It is typical to experience some bleeding after hemorrhoid ligation, especially if there is straining during bowel movements. The ligation process can cause the tissue to become more sensitive, and hard stools can exacerbate this issue.

2. Signs of Complications: While some bleeding can be normal, there are specific signs that should prompt you to seek medical attention. These include:
- Significant or persistent bleeding that does not stop after a few minutes.

- Blood that is bright red and appears in large amounts.

- Symptoms of infection, such as fever, increased pain, or swelling around the surgical site.

- Severe pain that is not relieved by over-the-counter pain medications.

3. Bowel Movements: It is crucial to manage bowel movements post-surgery to prevent further trauma to the surgical site. If you are experiencing hard stools, consider the following:
- Dietary Adjustments: Increase your fiber intake through fruits, vegetables, and whole grains. This can help soften your stool.

- Hydration: Drink plenty of fluids to help keep your stool soft.

- Stool Softeners: If your doctor has prescribed stool softeners or recommended over-the-counter options, use them as directed to ease bowel movements.

4. Follow-Up Care: Since you are experiencing increased bleeding after bowel movements, it is advisable to contact your healthcare provider. While your doctor may have indicated that things were improving, the new symptoms you are experiencing could indicate that the surgical site is being irritated or that there may be another issue at play.

5. When to Seek Help: If the bleeding continues or worsens, or if you develop any new symptoms, it is essential to seek medical attention sooner rather than later. It is better to err on the side of caution, especially when it comes to post-surgical care.

In conclusion, while some bleeding after hemorrhoid ligation can be normal, the increase in bleeding you are experiencing is concerning. It is recommended that you reach out to your healthcare provider to discuss your symptoms and determine whether a follow-up appointment is necessary. Managing your bowel movements effectively and monitoring your symptoms closely will be key to your recovery.

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