Post-Operative Pain Management After Rubber Band Ligation for Hemorrhoids

Postoperative care after rubber band ligation for internal hemorrhoids?

I experienced severe pain immediately after undergoing rubber band ligation for internal hemorrhoids, accompanied by a feeling of weakness throughout my body, making it nearly impossible to sit down.
The physician only advised me to take pain medication promptly and did not require a follow-up visit.
I took the prescribed pain medication (weren enteric) as soon as I left the clinic and rested in bed for about 2 to 3 hours, during which my hands and feet felt cold, before I felt some relief, as the pain was unbearable.
I finished the three-day supply of medication in just two days and decided to take one pill each in the morning, afternoon, and evening.
I found that if I stopped taking the pain medication, the pain would return to a level similar to right after the surgery.
However, if I continued to purchase and take the pain medication, I felt better, although the pain during bowel movements was still sharp, akin to being cut, even after three days.
I noticed that the physician mentioned that if there is severe pain, I could return for a follow-up.
Would my situation be considered "severe pain"? If I can tolerate the pain with ongoing medication, does that mean it is not severe? If I do return for a follow-up, what would the likely course of action be? Would there be other interventions, or would I just continue to receive pain medication? After any intervention, would my previous progress be compromised? I would appreciate your guidance, doctor.

Niming, 20~29 year old female. Ask Date: 2022/02/16

Dr. Zhang Shuhao reply Surgery

Normal rubber band ligation should not cause pain; some individuals may experience slight swelling and a foreign body sensation, but most people feel nothing at all.
If pain is felt during the ligation, it indicates that the ligation site is incorrect, and the rubber band must be removed immediately.
It is advisable to return for a follow-up as soon as possible.
The rubber band can be removed, and if the situation is severe, direct hemorrhoidectomy may be considered.

Reply Date: 2022/02/16

More Info

Post-operative pain management after rubber band ligation for hemorrhoids can be a challenging experience for many patients. It is not uncommon for individuals to experience significant discomfort following the procedure, which is designed to treat internal hemorrhoids by cutting off their blood supply, leading to their eventual shrinkage and elimination.
In your case, the intense pain you experienced immediately after the procedure, along with the feeling of weakness and cold extremities, suggests that your body was reacting strongly to the surgical intervention. This level of pain, particularly if it is severe enough to interfere with your ability to sit comfortably, can be classified as "acute pain." Acute pain is a common response to surgical procedures and can vary greatly among individuals based on factors such as pain tolerance, the extent of the procedure, and individual healing responses.

The fact that you were instructed to take pain medication and that you experienced relief after a few hours of rest indicates that your pain was likely expected post-operatively. However, the need to consume the medication more frequently than prescribed, and the persistence of pain during bowel movements, raises concerns about your recovery process. It's important to note that while some discomfort is expected, especially during bowel movements, the pain should gradually decrease as you heal.

If you find that stopping the pain medication leads to a return of severe pain, it may be indicative of inadequate pain control or an underlying issue that needs to be addressed. It is crucial to communicate openly with your healthcare provider about your pain levels and any changes you experience. If your pain is severe enough to warrant concern, it would be advisable to return to your doctor for a follow-up appointment.
During a follow-up visit, your physician may perform a physical examination to assess the surgical site for any complications, such as infection or excessive swelling. They may also evaluate your pain management regimen to ensure it is appropriate for your needs. If necessary, they could adjust your pain medications, prescribe a different type of analgesic, or recommend additional treatments to help manage your discomfort.

It is also essential to consider non-pharmacological approaches to pain management. Techniques such as applying ice packs to the affected area, practicing relaxation techniques, and ensuring a high-fiber diet to ease bowel movements can be beneficial. Additionally, staying well-hydrated and using stool softeners may help reduce pain during bowel movements, which is often a significant source of discomfort after hemorrhoid surgery.

In summary, while experiencing significant pain after rubber band ligation is not uncommon, it is essential to monitor your symptoms closely. If your pain persists or worsens, do not hesitate to seek medical advice. Your healthcare provider can help determine the best course of action to alleviate your pain and ensure a smooth recovery. Remember, effective pain management is a critical component of post-operative care, and your comfort should be a priority in your healing process.

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