Post-Procedure Concerns After Internal Hemorrhoid Banding Surgery

Post-operative issues after hemorrhoid ligation?

Hello Doctor: On August 5th, I visited a colorectal surgeon due to some pain in my anus, and the diagnosis was internal hemorrhoids.
I underwent a hemorrhoid ligation procedure, and for the following week, I used suppositories.
After my follow-up appointment on August 12th, the doctor said that the hemorrhoid had fallen off and there were no other issues, so he prescribed a hemorrhoid ointment for me to apply.

1.
However, sometimes after having a bowel movement and applying the ointment, I still feel some pain in a certain area inside the anus.
I have a history of chronic anal fissures, so I'm unsure whether the pain is from the internal hemorrhoid site or the fissure.
I haven't experienced any bleeding or swelling, and I am not constipated.
Is this a normal phenomenon? Do I need to see a doctor again?
2.
Can the hemorrhoid ligation procedure lead to issues such as anal abscesses or anal fistulas? I am very concerned about the possibility of developing either of these conditions.
3.
When applying the hemorrhoid ointment, I use my finger to insert it.
Could this cause any serious issues in the anal area?

Liu Xiaojie, 20~29 year old female. Ask Date: 2020/08/15

Dr. Ke Fangxu reply Surgery

1.
Mild pain after bowel movements is usually not a serious issue; sometimes it can occur with either hard or loose stools.
A warm water sitz bath should help alleviate the discomfort.
If symptoms do not improve or if there is severe pain, it is important to consult a physician for evaluation.

2.
No.
3.
If there are no scratches caused by long nails, there should be no issues.
It is generally recommended to wear gloves when applying ointments or to use the tube that comes with the medication for application.

Reply Date: 2020/08/15

More Info

After undergoing internal hemorrhoid banding surgery, it is common for patients to have concerns about post-procedure symptoms and potential complications. Let's address your questions one by one.

1. Post-Operative Pain: It is not unusual to experience some discomfort or pain in the anal area after the procedure, especially if you have a history of chronic anal fissures. The pain you feel could be due to the healing process of the internal hemorrhoid site or the existing fissure. Since you mentioned that you do not have bleeding or swelling and that you are not experiencing constipation, this suggests that your symptoms may be within the normal range of post-operative recovery. However, if the pain persists or worsens, it is advisable to consult your doctor for further evaluation. They may perform an examination to determine if the pain is related to the hemorrhoid surgery or if it is due to the chronic fissure.

2. Risk of Complications: Internal hemorrhoid banding is generally a safe procedure, but like any medical intervention, it carries some risks. The development of anal abscesses or fistulas (an abnormal connection between the anal canal and the skin) is rare but possible. These complications can occur if there is an infection or if the tissue does not heal properly. If you experience increased pain, fever, or any unusual discharge from the anal area, you should seek medical attention promptly. Your healthcare provider can assess your symptoms and determine if further treatment is necessary.

3. Application of Hemorrhoid Ointment: When applying hemorrhoid ointment, it is important to follow the instructions provided by your doctor or the product packaging. Using your finger to apply the ointment internally is common practice, but you should ensure that your hands are clean to minimize the risk of introducing bacteria into the anal area. If you are concerned about causing additional issues, you might consider using an applicator if one is provided with the ointment. It's essential to be gentle during application to avoid aggravating any existing fissures or causing trauma to the area.

In summary, while some discomfort after internal hemorrhoid banding is normal, persistent or worsening pain should be evaluated by your healthcare provider. The risks of serious complications like abscesses or fistulas are low, but they warrant attention if symptoms arise. Lastly, proper hygiene during the application of ointments can help prevent further complications. Always feel free to reach out to your healthcare provider with any concerns, as they can provide personalized advice based on your medical history and current condition.

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