Post-Hemorrhoid Banding: Why Am I Experiencing Bleeding and Pain?

Bleeding during bowel movements one month after hemorrhoid ligation?

A few months ago, I experienced continuous rectal bleeding during bowel movements.
After a doctor's examination, I underwent a hemorrhoid ligation surgery in early March of this year.
However, a few days ago, I started experiencing persistent pain during and after bowel movements, and I have noticed bleeding again in the past two days.
1.
Could this indicate that the ligation was unsuccessful? 2.
Should I seek a doctor's evaluation? Thank you.

Chen, 20~29 year old female. Ask Date: 2020/04/13

Dr. Ke Fangxu reply Surgery

1.
Hemorrhoid ligation is primarily a treatment for symptom control, and symptoms may recur.
If there is bleeding again more than a month after the ligation, you can consult your physician for another ligation.

2.
Although the probability of developing colorectal cancer at the age of 25 is not zero, it is generally very low.
Based on your description, it seems more likely to be hemorrhoidal bleeding.
It is recommended to maintain a light diet and a good lifestyle.
Spicy, irritating, and greasy foods should be avoided, and increasing dietary fiber intake can also be beneficial.
If symptoms persist without improvement, you may consult your physician for medication or to undergo a colonoscopy.

Reply Date: 2020/04/13

More Info

After undergoing hemorrhoid banding surgery, experiencing bleeding and pain can be concerning. It's important to understand that while some discomfort and minor bleeding can be normal post-procedure, persistent or worsening symptoms warrant further evaluation. Here’s a detailed explanation addressing your concerns:
1. Is the banding unsuccessful?
Hemorrhoid banding is generally a safe and effective procedure for treating internal hemorrhoids. However, complications can occur. The presence of bleeding and pain after the procedure does not necessarily indicate that the banding was unsuccessful. It could be a result of several factors, including:
- Post-operative inflammation: After the banding, the tissue around the hemorrhoid may become inflamed, leading to pain and discomfort.

- Residual hemorrhoids: Sometimes, not all hemorrhoids are treated during the procedure, or new hemorrhoids can develop post-surgery.

- Anal fissures: The trauma from the procedure or from passing hard stools can lead to fissures, which can cause significant pain and bleeding.

- Infection: Although rare, infections can occur post-surgery, leading to increased pain and bleeding.

2. Should you see a doctor?
Yes, it is advisable to consult your doctor or a gastroenterologist if you are experiencing ongoing pain and bleeding after hemorrhoid banding. They may perform a physical examination and possibly recommend further diagnostic tests, such as an anoscopy, to assess the surgical site and rule out complications. Early intervention can help manage symptoms and prevent further complications.

Additional Considerations
- Diet and Hydration: Ensure you are consuming a high-fiber diet and staying well-hydrated. This can help soften stools and reduce straining during bowel movements, which is crucial for recovery.

- Pain Management: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, may help alleviate discomfort. However, consult your doctor before taking any medication, especially if you have other health conditions or are on other medications.

- Follow-Up Care: Regular follow-up appointments with your healthcare provider are essential to monitor your recovery and address any complications early on. If your symptoms persist or worsen, do not hesitate to seek medical attention.

Conclusion
In summary, while some bleeding and pain can be expected after hemorrhoid banding, persistent symptoms should not be ignored. It is crucial to follow up with your healthcare provider to ensure proper healing and to rule out any complications. Taking proactive steps in your diet and pain management can also aid in your recovery. Your health and comfort are paramount, so don’t hesitate to reach out for help when needed.

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