Post-Procedure Symptoms After Hemorrhoid Ligation

Rubber band ligation for internal hemorrhoids?

Dear Doctor: I underwent a hemorrhoid ligation on August 27, and I have been experiencing a feeling of fullness in the anal area ever since.
My bowel movements are normal, and there has been no bleeding.
Given that it has been about 10 days, should the hemorrhoids have fallen off by now? How can I tell if they have fallen off? Do I need to schedule a follow-up appointment? Is this feeling of fullness normal? Thank you.

Da Bao, 30~39 year old female. Ask Date: 2021/09/04

Dr. Ke Fangxu reply Surgery

After rubber band ligation for internal hemorrhoids, do not worry about whether the rubber band has fallen off.
As long as there is no severe pain or significant bleeding postoperatively, there is no cause for concern.
A feeling of swelling in the anal area is normal.
If you must know whether the band has fallen off, you will need to have a digital rectal examination or an anoscopy performed by a physician to confirm.

Reply Date: 2021/09/04

More Info

After undergoing hemorrhoid ligation, it is common for patients to experience a variety of post-procedure symptoms, including a sensation of fullness or pressure in the anal area, which you are describing as a "肛門漲漲的感覺" (a feeling of fullness in the anus). This sensation can persist for several days to weeks following the procedure, and it is often due to the presence of the ligated hemorrhoid tissue, which may take some time to fall off.

Typically, after hemorrhoid ligation, the ligated tissue will begin to necrose (die) and eventually slough off, usually within 7 to 14 days post-procedure. Since you mentioned that it has been about 10 days since your procedure, it is possible that the ligated tissue is nearing the point of detachment. However, the exact timing can vary from person to person.

To determine if the tissue has fallen off, you may not necessarily need to visually inspect the area, as this can be uncomfortable and not always feasible. Instead, you can monitor for changes in your symptoms. If the sensation of fullness decreases or if you notice any changes in your bowel movements, such as a reduction in discomfort during defecation, it may indicate that the tissue has detached.

Regarding your question about whether you need to return for a follow-up appointment, it is generally advisable to consult your healthcare provider if you have persistent symptoms, such as the fullness sensation, that do not improve or if you experience any new symptoms, such as bleeding, severe pain, or changes in bowel habits. Your doctor can perform an examination to assess the healing process and ensure that there are no complications, such as infection or incomplete ligation.

In summary, experiencing a feeling of fullness in the anal area after hemorrhoid ligation is not uncommon, and it may take some time for the ligated tissue to fall off. Monitoring your symptoms and consulting your healthcare provider if you have concerns or if symptoms persist is the best course of action. If you have any doubts or if your symptoms worsen, do not hesitate to seek medical advice.

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