Post-Banding Pain and Bleeding After Hemorrhoid Surgery

Hemorrhoid ligation: soreness for 4-5 hours after bowel movement?

Hello Dr.
Ke,
I underwent rubber band ligation for internal hemorrhoids on February 1st in the U.S.
(as a student).
Starting from February 10th, I have noticed a small amount of blood during bowel movements, along with a 5-7 out of 10 level of pain at the ligation site, which sometimes lasts for 4-5 hours, making it difficult for me to sit or stand comfortably.
The medical advice I received includes warm sitz baths, no suppositories, and the external use of lidocaine and prilocaine cream.
Is this situation normal? Thank you for your response.

Mrs. Hsu, 30~39 year old female. Ask Date: 2021/02/12

Dr. Ke Fangxu reply Surgery

If the location of the internal hemorrhoid ligation is too close to the anal opening, it can indeed cause a sensation of discomfort and pain.
It is generally recommended to take analgesics and to perform warm sitz baths.
If the pain is severe, it is necessary to consult a physician to remove the ligated rubber band to alleviate the symptoms.

Reply Date: 2021/02/12

More Info

After undergoing a hemorrhoid banding procedure, it is not uncommon to experience some discomfort and minor bleeding. Your symptoms of mild bleeding and pain at the site of the banding are generally considered normal, especially in the days following the procedure. However, it is essential to monitor these symptoms closely and understand what is typical and what may require further medical attention.

Understanding Post-Banding Symptoms
1. Bleeding: It is typical to see a small amount of blood in your stool or on toilet paper after a hemorrhoid banding procedure. This can occur as the tissue around the banded hemorrhoid begins to heal and slough off. The bleeding should be minimal and should not last for an extended period. If you notice significant bleeding (more than a few drops) or if the bleeding persists, you should contact your healthcare provider.

2. Pain and Discomfort: Pain levels can vary significantly from person to person. The discomfort you describe (5-7 out of 10) is not unusual, especially if it lasts for several hours. The pain is often due to inflammation and the healing process of the tissue where the band was placed. It is important to follow your doctor's advice regarding pain management, which may include over-the-counter pain relievers or prescribed medications.

3. Sitz Baths: Your doctor has recommended warm sitz baths, which can be very beneficial. Soaking in warm water can help soothe the area, reduce pain, and promote healing. Aim for 15-20 minutes of soaking several times a day, especially after bowel movements.

4. Topical Treatments: The use of lidocaine and prilocaine cream can help numb the area and provide temporary relief from pain. Ensure you apply it as directed by your physician. Avoid using any other topical treatments unless advised by your doctor, as they may interfere with the healing process.

5. Bowel Movements: It is crucial to maintain soft stools to avoid straining during bowel movements, which can exacerbate pain and bleeding. Consider increasing your fiber intake through diet or supplements, and ensure you stay well-hydrated.

When to Seek Medical Attention
While some discomfort and minor bleeding are expected, certain symptoms warrant a call to your healthcare provider:
- Severe Bleeding: If you experience heavy bleeding or blood clots.

- Increased Pain: If your pain worsens significantly or does not improve with prescribed pain management.

- Signs of Infection: Symptoms such as fever, chills, or increased redness and swelling around the surgical site.

- Persistent Symptoms: If your symptoms do not improve after a week or worsen over time.

Conclusion
In summary, your symptoms following the hemorrhoid banding procedure appear to be within the range of normal post-operative experiences. However, it is essential to remain vigilant and proactive about your recovery. Following your doctor's instructions regarding pain management, sitz baths, and dietary adjustments will aid in your healing process. If you have any concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your health and comfort are paramount, and staying informed about your recovery will help you navigate this period more effectively.

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