Post-Banding Hemorrhoids: What to Expect After Surgery

There is a lump at the anal opening after the vasectomy?

Hello Dr.
Ke, I underwent rubber band ligation surgery in mid-June.
Since the surgery until today, I have been able to have bowel movements every day without any blood in my stool, and I thought I had fully healed.
However, in the past week or two, I have started to feel a small lump at the anal opening that I need to push back with my finger.
It is not painful, and it usually disappears for a while after a bowel movement, but I can feel it coming out again if I walk for too long.
Could this be due to the internal hemorrhoid that was ligated not having completely fallen off? How long does it typically take for ligated internal hemorrhoids to fall off? The doctor mentioned that my internal hemorrhoids were not small, so does the time for them to fall off vary based on their size? Recently, I would like to avoid going to the hospital as much as possible.
If I maintain regular bowel movements without any bleeding, can I just ignore it? Thank you, Dr.
Ke.
^^

Niming, 30~39 year old female. Ask Date: 2020/08/04

Dr. Ke Fangxu reply Surgery

After two months of hemorrhoid banding, the occurrence of prolapse is likely unrelated to the rubber band ligation procedure.
Typically, the band will fall off within 7-10 days, and the wound should heal completely within a month.
This prolapse may be caused by another hemorrhoid.
If the hemorrhoid is not painful or bleeding, invasive treatment may not be necessary.
It is advisable to avoid constipation during this period, shorten the time spent on bowel movements, and increase dietary fiber intake, which can be helpful.
Warm sitz baths may also aid in alleviating symptoms.
Over-the-counter hemorrhoid suppositories can be used, but it is best to avoid laxatives unless necessary.
If symptoms persist without improvement, it is recommended to consult a physician for evaluation.

Reply Date: 2020/08/04

More Info

After undergoing rubber band ligation for hemorrhoids, it's common to experience some changes and sensations in the anal area as the body heals. Your description of feeling a "meatball" at the anal opening that requires manual adjustment is not unusual and can be attributed to several factors related to the healing process.

Understanding the Healing Process
1. Post-Procedure Expectations: After rubber band ligation, the internal hemorrhoids are expected to undergo necrosis (tissue death) due to the lack of blood supply from the ligation. This process typically takes about 1 to 2 weeks, but it can vary based on the size of the hemorrhoids and individual healing rates. Larger hemorrhoids may take longer to fall off.

2. What You’re Experiencing: The sensation of a lump or "meatball" at the anal opening could indicate that the ligated hemorrhoid has not yet completely fallen off or that there is some residual tissue. It’s also possible that you are feeling the remaining tissue of the hemorrhoid or even a prolapsed hemorrhoid, which can occur if the ligation was not entirely successful or if there is still some swelling.

3. Duration of Symptoms: Generally, if the ligation was successful, the hemorrhoid should fall off within 1 to 2 weeks post-procedure. However, if you are still feeling a lump after this period, it may warrant further evaluation.

When to Seek Medical Attention
- Persistent Symptoms: If the lump persists beyond a couple of weeks or if you experience any new symptoms such as pain, bleeding, or significant discomfort, it is advisable to consult your physician. While you mentioned that the lump is not painful, any changes in symptoms should be monitored closely.

- Signs of Complications: If you notice any signs of infection (such as increased redness, swelling, or discharge), or if the lump becomes painful, you should seek medical attention promptly.

Self-Care and Management
- Bowel Movements: Maintaining soft stools is crucial to avoid straining during bowel movements, which can exacerbate hemorrhoid symptoms. Continue to ensure you are consuming a high-fiber diet, staying hydrated, and possibly using stool softeners if necessary.

- Monitoring: If the lump does not cause pain or bleeding and you are comfortable, you may choose to monitor it for a short period. However, keep a close eye on any changes in size, shape, or associated symptoms.

- Avoiding Irritation: Be cautious with activities that may irritate the area, such as prolonged sitting or heavy lifting, as these can exacerbate symptoms.

Conclusion
In summary, what you are experiencing after your rubber band ligation is not uncommon, but it is essential to monitor your symptoms closely. If the lump persists or if you have any concerns about your recovery, do not hesitate to reach out to your healthcare provider for further evaluation. They can provide reassurance, assess for any complications, and guide you on the best course of action moving forward. Your health and comfort are paramount, and it’s always better to err on the side of caution when it comes to post-operative care.

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