Rubber band ligation for internal hemorrhoids
Hello Dr.
Ke, I had a hemorrhoid ligation on October 15th.
Yesterday, on October 24th, I noticed a small amount of blood when I used the restroom, and today there was a little blood when I wiped.
Is this normal? The bleeding only occurs when I wipe, and it's not a lot.
After the ligation, my hemorrhoids protrude during bowel movements, and I push them back in with medication.
Is this okay? Could this be the reason for the bleeding? It's been 10 days since the ligation, and I still feel some pain inside when my anal sphincter contracts, similar to a wound.
Is this normal? I apologize for bothering you, Dr.
Ke.
Niu Niu, 30~39 year old female. Ask Date: 2021/10/25
Dr. Ke Fangxu reply Surgery
If the bleeding is not significant, there is no need to worry.
The reason for ligating internal hemorrhoids is that if the hemorrhoids are already prolapsed, it is possible that they may not fully improve after ligation.
This phenomenon may require multiple ligation procedures to completely resolve.
Theoretically, hemorrhoid ligation should not be painful; however, if the ligation site is closer to the anal opening, some mild discomfort is normal.
Reply Date: 2021/10/25
More Info
After undergoing hemorrhoid ligation, it's not uncommon to experience some post-operative symptoms, including minor bleeding, discomfort, and changes in bowel habits. Let's break down your concerns regarding the bleeding, pain, and the behavior of the hemorrhoids post-surgery.
1. Bleeding After Hemorrhoid Ligation: It is relatively normal to see a small amount of blood after hemorrhoid ligation, especially within the first two weeks post-procedure. The ligation process involves placing a rubber band around the base of the hemorrhoid, which cuts off its blood supply. As the hemorrhoid shrinks and eventually falls off, some bleeding can occur. If the bleeding is minimal and only occurs during wiping, it may not be a cause for concern. However, if you notice a significant increase in bleeding, or if it is accompanied by severe pain or other symptoms, you should contact your healthcare provider.
2. Hemorrhoids Prolapse: It’s also common for the hemorrhoids to protrude during bowel movements, especially in the early recovery phase. If you can gently push them back in after a bowel movement, that is generally acceptable. However, avoid excessive force, as this could exacerbate bleeding or discomfort. If the hemorrhoids continue to prolapse or if you experience significant pain, it may be worth discussing with your doctor.
3. Pain and Discomfort: Experiencing pain during bowel movements or when the anal sphincter contracts is not unusual after hemorrhoid ligation. This pain can be due to the healing process of the tissue and the irritation caused by bowel movements. It’s important to maintain a soft stool to minimize straining, which can aggravate the area. Staying hydrated, consuming a high-fiber diet, and possibly using stool softeners can help ease this discomfort.
4. Post-Operative Care: After hemorrhoid ligation, it’s crucial to follow your doctor’s post-operative care instructions. This may include recommendations for pain management, dietary adjustments, and hygiene practices. If you are using topical medications, ensure they are appropriate for post-surgical care and follow the instructions provided by your healthcare provider.
5. When to Seek Medical Attention: While some bleeding and discomfort are expected, you should seek medical attention if you experience any of the following:
- Heavy bleeding (more than a few drops)
- Severe pain that is not relieved by over-the-counter pain medications
- Signs of infection, such as increased redness, swelling, or discharge from the surgical site
- Persistent or worsening symptoms beyond the expected recovery period
In summary, while some bleeding and discomfort are normal after hemorrhoid ligation, it’s essential to monitor your symptoms closely. If you have any concerns or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. They can provide personalized advice based on your specific situation and ensure that your recovery progresses smoothly.
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