Post-Surgery Concerns: Hemorrhoid Banding and Recovery - Surgery

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Regarding the previous question and post-operative care after hemorrhoid ligation?


Hello, Doctor.
I am the patient referred to as "Umbrella" in the previous discussion.
After undergoing rubber band ligation for internal hemorrhoids the day before yesterday, I noticed a swollen and protruding area in the center of the anal opening while taking a warm sitz bath, which I did not have after the ligation.
Is this normal? Additionally, regarding the small bump above the anal opening that I described previously, you mentioned it is an external hemorrhoid.
Does this mean it is classified as a grade IV hemorrhoid? Thank you very much for your response!

yǔsǎn, 20~29 year old female. Ask Date: 2020/07/23

Dr. Ke Fangxu reply Surgery


After hemorrhoid ligation, the surrounding tissue may swell, which could lead to the lump you mentioned; however, a diagnosis cannot be made without visual examination.
This should not be classified as grade IV hemorrhoids.
True grade IV hemorrhoids refer to swollen hemorrhoidal tissue that protrudes from the anus and cannot be pushed back in.

Reply Date: 2020/07/23

More Info


After undergoing hemorrhoid banding, it's not uncommon for patients to experience some swelling or protrusion around the anal area. This can be particularly noticeable during activities such as warm sitz baths, where the increased blood flow to the area can exacerbate any swelling. The presence of a swollen area at the anal opening could be a result of the procedure itself, as the banding can lead to inflammation and temporary changes in the surrounding tissues.
In your case, the swelling you are feeling may be a normal part of the healing process. However, it is essential to monitor this swelling closely. If the swelling persists, increases, or is accompanied by significant pain, bleeding, or any signs of infection (such as fever or discharge), you should contact your healthcare provider promptly. They can assess whether this is a normal post-operative symptom or if further intervention is necessary.

Regarding the lump you described as being the size of a corn kernel above the anal opening, if it was identified as an external hemorrhoid, it may indeed indicate a more advanced stage of hemorrhoids, potentially grade IV. Hemorrhoids are classified based on their severity, with grade IV being the most severe, where the hemorrhoids are prolapsed and cannot be pushed back inside. It's important to clarify this with your physician, as they can provide a definitive diagnosis based on a physical examination.

Post-surgery, it is crucial to follow your doctor's recommendations for recovery. This typically includes maintaining a high-fiber diet to prevent constipation, staying hydrated, and possibly using stool softeners. Gentle hygiene practices and warm sitz baths can help alleviate discomfort and promote healing. Avoiding straining during bowel movements is also essential, as this can exacerbate symptoms and hinder recovery.

In terms of recovery time, most patients experience significant improvement within a few weeks, but complete healing can take longer. Regular follow-up appointments with your healthcare provider will help ensure that your recovery is on track and that any complications are addressed promptly.

In summary, while some swelling and discomfort after hemorrhoid banding can be normal, it's essential to remain vigilant and communicate any concerning symptoms to your healthcare provider. They will be able to provide you with the best advice tailored to your specific situation and ensure a smooth recovery process.

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