Post-Banding Bleeding After Internal Hemorrhoid Treatment: What to Know

Post-banding bleeding after hemorrhoid banding?

Hello, Doctor.
I had a hemorrhoid ligation on October 11, and since then, I have not had a bowel movement until today, October 13.
However, during today's bowel movement, there was some bleeding.
Unlike the previous bleeding from the hemorrhoids that occurred during wiping, this time there appeared to be red blood on a couple of the stools.
Additionally, today's stools were somewhat hard and resembled sheep feces, although I have been taking the stool softeners prescribed by the doctor as usual.
I would like to ask the doctor whether this bleeding is due to the hemorrhoids or if it could be from another cause.
Should I return for a follow-up appointment?

Meng, 20~29 year old female. Ask Date: 2022/10/13

Dr. Ke Fangxu reply Surgery

After hemorrhoid ligation, it is indeed possible to experience slight bleeding.
As long as there is no significant or continuous bleeding, it should not be a concern.
If the stool is too hard after the procedure, this may exacerbate the issue.
A follow-up visit is generally not necessary at this time, but it is essential to avoid constipation.
In addition to taking stool softeners, increasing the intake of dietary fiber and fluids is also necessary.

Reply Date: 2022/10/13

More Info

Post-banding bleeding after internal hemorrhoid treatment can be concerning, especially if you notice blood during bowel movements. It's important to understand the potential causes and when to seek further medical attention.

After undergoing a banding procedure for internal hemorrhoids, it is not uncommon to experience some bleeding. This can occur due to the nature of the procedure, which involves placing a rubber band around the base of the hemorrhoid to cut off its blood supply. As the hemorrhoid tissue dies and sloughs off, it can lead to some bleeding. Typically, this bleeding is minimal and should resolve on its own within a few days.

However, the presence of bright red blood on your stool or toilet paper, especially if it appears more than just a few drops, can indicate a few different issues:
1. Normal Post-Procedure Bleeding: As mentioned, some bleeding can be expected after banding. If the blood is bright red and not mixed with stool, it may be from the hemorrhoid site.

2. Hard Stools: You mentioned that your stools were hard and resembling "sheep-like" stools. Straining during bowel movements can exacerbate bleeding from hemorrhoids or even cause new fissures, leading to additional bleeding. It's crucial to maintain soft stools to minimize straining.

3. Other Causes: While less common, other gastrointestinal issues could lead to rectal bleeding. These might include anal fissures, diverticular disease, or even more serious conditions like colorectal polyps or cancer, especially if the bleeding persists or is accompanied by other symptoms such as pain, changes in bowel habits, or weight loss.

Given that you have not had a bowel movement for a couple of days and then experienced bleeding, it is advisable to monitor the situation closely. Here are some recommendations:
- Hydration and Diet: Ensure you are drinking plenty of fluids and consuming a diet rich in fiber to help soften your stools. This can help prevent further straining during bowel movements.

- Use of Stool Softeners: Continue taking the stool softeners as prescribed by your doctor. If you find they are not effective, consult your physician about adjusting the dosage or trying a different product.

- Monitor Symptoms: Keep an eye on the amount of bleeding. If it increases, or if you experience significant pain, dizziness, or any other concerning symptoms, you should seek medical attention promptly.

- Follow-Up Appointment: It is generally a good idea to follow up with your doctor after any surgical procedure, especially if you notice new or concerning symptoms. They can assess whether the bleeding is within the normal range or if further intervention is needed.

In summary, while some bleeding after hemorrhoid banding can be normal, the characteristics of your bleeding and the hardness of your stools suggest that you should take steps to manage your bowel health actively. If the bleeding continues or worsens, do not hesitate to return to your healthcare provider for further evaluation. They can provide the best guidance based on your specific situation and medical history.

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