Immediate Release After Hemorrhoid Banding: Concerns and Care

The ligation of two internal hemorrhoids should be released immediately?

Hello, two days ago I underwent rubber band ligation for internal hemorrhoids at the hospital.
After the doctor completed the procedure on one hemorrhoid, he discovered another one near the anal opening.
After ligating this one, I experienced severe pain and difficulty urinating, so half an hour later, the doctor removed the rubber band from the hemorrhoid near the anal opening, emphasizing that it was still at a safe distance from the skin.
During the removal process, there was some damage and bleeding, but my condition improved, and the urinary difficulty was resolved.
However, after returning home, I still have pain at the anal opening and ongoing slight bleeding, and I feel that the tissue in that area has become a bit hardened.

1.
Will removing the rubber band half an hour after ligation have any impact on the rectal tissue? Is there a risk of tissue necrosis or deformation?
2.
Given that I am still experiencing pain at the anal opening, what can I do now?

Xiao Chen, 30~39 year old female. Ask Date: 2021/01/22

Dr. Ke Fangxu reply Surgery

1.
Severe pain after a vasectomy that does not resolve may indicate that the surgical site is too close to the anus, which may not affect the rectal tissue.

2.
Taking pain relievers and using warm sitz baths.

Reply Date: 2021/01/22

More Info

After undergoing hemorrhoid banding, it's not uncommon to experience discomfort, pain, and even some bleeding. Your concerns about the procedure and its aftermath are valid, and I’ll address each of your questions based on medical knowledge and common practices in post-operative care.

1. Impact of Removing the Band Half an Hour After Placement:
The removal of the rubber band shortly after placement can have implications for the rectal tissue. Typically, the band is intended to cut off blood supply to the hemorrhoid, leading to its eventual necrosis and sloughing off. If the band was removed too soon, there is a possibility that the hemorrhoid may not have been adequately deprived of blood supply, which could affect the intended outcome. However, if the physician assessed that the banding was still appropriate and removed it to alleviate your immediate discomfort, it suggests that they were monitoring the situation closely.
As for tissue necrosis, it generally occurs when blood supply is completely cut off for an extended period. Since the band was only on for a short time, significant necrosis is unlikely. However, if there was bleeding during the removal process, it could indicate that some tissue was affected. The hardening of the tissue you are feeling could be due to inflammation or the formation of scar tissue as part of the healing process. It’s essential to monitor the area for signs of infection, such as increased redness, swelling, or discharge.

2. Managing Ongoing Pain and Discomfort:
Experiencing pain after hemorrhoid banding is common, especially in the first few days post-procedure. Here are some recommendations to help manage your discomfort:
- Pain Relief: Over-the-counter pain relievers such as acetaminophen or ibuprofen can be effective in managing pain. Always follow the dosage instructions on the package or those provided by your healthcare provider.

- Warm Sitz Baths: Taking warm sitz baths can help soothe the area and promote blood flow, which may aid in healing. Aim for 10-15 minutes several times a day, especially after bowel movements.

- Dietary Adjustments: To prevent constipation and straining during bowel movements, increase your fiber intake through fruits, vegetables, and whole grains. Staying hydrated is also crucial.

- Avoid Straining: If you feel the urge to have a bowel movement, try not to strain. If necessary, consider using a stool softener to ease the process.

- Monitor Symptoms: Keep an eye on your symptoms. If the pain worsens, or if you notice significant bleeding (more than a few drops), fever, or signs of infection, you should contact your healthcare provider promptly.

In conclusion, while the removal of the band shortly after placement may have some implications, it is unlikely to cause significant long-term damage if managed properly. Your ongoing pain and discomfort are expected, but with appropriate care and monitoring, you should see improvement. If you have any concerns or if your symptoms do not improve, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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