White Lump After Rubber Band Ligation for Internal Hemorrhoids: What to Know

After rubber band ligation for internal hemorrhoids, there is a white mass present?

Hello, doctor.
I had rubber band ligation for internal hemorrhoids a week ago.
I'm not sure if the rubber band has fallen off.
Upon self-examination, I noticed a piece of tissue at the anal opening that appears white, while the rest is the normal color of anal skin.
I would like to ask if that white tissue is about to fall off, or if it is inflamed, or something else? THANKS.

Xiao Sai, 40~49 year old female. Ask Date: 2020/01/18

Dr. Ke Fangxu reply Surgery

There is no need to worry about whether the rubber band has fallen off; as long as the symptoms of bleeding or prolapse improve, that is sufficient.
The wound from hemorrhoid ligation is typically not visible externally.
Regarding the white area you mentioned in the lump, I cannot provide a definitive answer without a personal examination.

Reply Date: 2020/01/18

More Info

After undergoing rubber band ligation for internal hemorrhoids, it's not uncommon to notice changes in the appearance of the anal area, including the presence of white lumps or spots. The white lump you are observing could be attributed to several factors, and understanding these can help alleviate your concerns.

1. Necrosis of the Tissue: After rubber band ligation, the tissue that is being ligated (the hemorrhoid) will undergo a process of necrosis. This means that the blood supply to the hemorrhoid is cut off, leading to its eventual death and sloughing off. The white appearance you see could be necrotic tissue that is in the process of detaching. This is a normal part of the healing process, and the necrotic tissue may appear white or grayish.

2. Inflammation: Post-procedure inflammation is also common. The area may become irritated and inflamed, which can lead to changes in color and texture. If the white lump is accompanied by significant pain, swelling, or discharge, it may indicate an inflammatory response or infection.

3. Healing Process: The healing process after rubber band ligation can vary from person to person. Some patients may experience a more pronounced inflammatory response, while others may heal with minimal symptoms. The presence of a white lump could simply be a part of the normal healing process, especially if it is not painful and there are no signs of infection.

4. Follow-Up Care: It is essential to monitor the area for any changes. If the white lump persists beyond a couple of weeks, increases in size, or is accompanied by other symptoms such as fever, increased pain, or unusual discharge, it is crucial to follow up with your healthcare provider. They may perform an examination to determine whether the lump is a normal part of healing or if it requires further intervention.

5. When to Seek Help: If you experience severe pain, bleeding that does not subside, or any signs of infection (such as fever or pus), you should seek medical attention promptly. These could be signs of complications that may need to be addressed.

In summary, the white lump you are observing after rubber band ligation could be a normal part of the healing process, possibly indicating necrotic tissue or inflammation. However, it is essential to keep an eye on it and consult your healthcare provider if you have any concerns or if symptoms worsen. Regular follow-up appointments are crucial to ensure proper healing and to address any complications that may arise.

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