Post-Surgery Bleeding After Hemorrhoid Ligation: What to Expect? - Surgery

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Bleeding 12 days after hemorrhoid ligation?


Hello, doctor.
I had a hemorrhoid ligation 12 days ago.
Until yesterday, my bowel movements were normal without any bleeding, and I did not see any hemorrhoid tissue (I also did not see any tissue or experience bleeding after ligating another hemorrhoid previously).

1.
Is it normal not to see any hemorrhoid tissue or experience bleeding after the ligation?
2.
Is it normal to have bleeding 12 days post-procedure? Today, after passing gas, I felt something unusual, almost like diarrhea, and I found a pool of blood in my underwear along with a soft, solid mass that resembled a blood clot.
I'm unsure if this is hemorrhoid tissue.
Later, when I tried to pass gas again, I experienced a significant amount of bleeding.
Is this normal?
3.
I have a follow-up appointment scheduled, but should I reduce bowel movements in the meantime to avoid straining the area and causing further bleeding? Thank you.

Yǔsǎn, 20~29 year old female. Ask Date: 2020/08/01

Dr. Ke Fangxu reply Surgery


1.
Hemorrhoids are not always visible, and if the bleeding is minimal, blood may not be noticeable.

2.
The bleeding could be from the ligation site or from hemorrhoids in other areas; if there is no persistent heavy bleeding, it is not a concern.

3.
After ligation, it is important to avoid constipation and shorten the time spent on bowel movements to prevent excessive straining that could lead to bleeding from the wound.

Reply Date: 2020/08/01

More Info


Post-surgery bleeding after hemorrhoid ligation can be a concerning issue, and it’s important to understand what to expect during the recovery process. Hemorrhoid ligation, also known as rubber band ligation, is a common procedure used to treat internal hemorrhoids by cutting off their blood supply, which causes them to shrink and eventually fall off. While many patients experience a smooth recovery, some may encounter complications such as bleeding or discomfort.

1. Expectations After Ligation: It is not uncommon for patients to not see the hemorrhoid or experience bleeding immediately after the procedure. In many cases, the ligated hemorrhoid will not be visible as it may have already begun to shrink or has fallen off. However, some patients may notice a small amount of bleeding or discharge as the area heals. The absence of visible hemorrhoids or bleeding does not necessarily indicate a problem; it can simply mean that the ligation was successful.

2. Bleeding After 12 Days: Experiencing bleeding 12 days post-procedure can be concerning, especially if it is accompanied by a sensation of discomfort or changes in bowel habits. While some minor bleeding can occur as part of the healing process, significant bleeding or the passage of clots should be evaluated by a healthcare professional. The presence of a soft, blood-like clot could indicate that the ligated hemorrhoid is either still present or that there is some other issue at play, such as a small tear or irritation in the anal area.

3. Managing Bowel Movements: It is advisable to be cautious with bowel movements following hemorrhoid ligation. Straining during bowel movements can increase the risk of bleeding and may disrupt the healing process. If you are experiencing diarrhea or loose stools, it is essential to manage this condition, as frequent bowel movements can irritate the surgical site. Increasing your fiber intake, staying hydrated, and possibly using stool softeners can help maintain regularity without straining. If you feel the urge to have a bowel movement, try to relax and avoid excessive pushing.

4. Follow-Up Care: Since you have already scheduled a follow-up appointment, it is crucial to discuss your symptoms with your healthcare provider. They can assess the situation and determine whether the bleeding is within the normal range or if further intervention is needed. They may also provide guidance on how to care for the area, including recommendations for sitz baths or topical treatments to alleviate discomfort.

5. When to Seek Immediate Care: If you experience heavy bleeding (more than a small amount), severe pain, or signs of infection (such as fever or increased swelling), it is important to seek medical attention promptly. These symptoms may indicate complications that require immediate evaluation.

In summary, while some bleeding can be expected after hemorrhoid ligation, significant or persistent bleeding should be addressed by a healthcare professional. Managing bowel movements carefully and following up with your doctor will help ensure a smoother recovery. Always prioritize communication with your healthcare provider regarding any concerns or unusual symptoms you may experience during your recovery process.

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