Post-Hemorrhoid Banding: Bleeding After Surgery

Post-banding bleeding after internal hemorrhoid ligation?

Hello Doctor, I underwent a hemorrhoid ligation surgery for grade II internal hemorrhoids three weeks ago.
Until now, I still notice a small amount of blood on the toilet paper after wiping, although the amount is minimal.
I feel this is abnormal and I'm worried whether the ligation was unsuccessful or if it has developed into a thrombosed hemorrhoid.
I would like to ask: 1.
The purpose of internal hemorrhoid ligation is to stop bleeding, so why is there still blood three weeks later? 2.
Given that three weeks should be enough time for complete recovery, I read that some doctors say as long as the bleeding is minimal, there is no need to worry.
How can I determine if the treatment was successful? Should I wait until there is no bleeding at all, or should I observe for a while longer and see a doctor if I still notice blood after wiping? Thank you!

Ào sī dīng, 20~29 year old female. Ask Date: 2022/10/27

Dr. Ke Fangxu reply Surgery

1.
Mild bleeding after hemorrhoid ligation is a normal phenomenon; however, if it persists for an extended period, medication treatment may be necessary.
2.
The indications for hemorrhoid ligation should be hemorrhoidal bleeding that is unresponsive to medical treatment.
If the amount of bleeding decreases after ligation, it can be considered a successful treatment.
Combining this with medication therapy and improved bowel habits can gradually help stop the bleeding.
If the bleeding does not improve, it may be necessary to undergo 1-2 additional hemorrhoid ligations or consider surgical intervention.

Reply Date: 2022/10/27

More Info

After undergoing hemorrhoid banding surgery, it's not uncommon to experience some bleeding, especially in the weeks following the procedure. Let's address your concerns regarding the bleeding and recovery process.

1. Why is there bleeding three weeks post-hemorrhoid banding?
Hemorrhoid banding is designed to cut off blood supply to the hemorrhoids, causing them to shrink and eventually fall off. However, the healing process can vary from person to person. It's possible that the tissue around the treated area is still healing, which can lead to minor bleeding. Factors such as bowel movements, straining, or even the presence of small fissures can contribute to this bleeding. If the bleeding is minimal and occurs only occasionally, it may not be a cause for alarm. However, if the bleeding increases or is accompanied by significant pain, it would be prudent to consult your healthcare provider.

2. How to determine if the treatment was successful?
Success in hemorrhoid banding is typically indicated by a reduction in symptoms such as pain, itching, and bleeding. While some residual bleeding can occur during the healing process, it should gradually decrease over time. If you notice that the bleeding is persistent or worsening after three weeks, it may warrant further evaluation. Generally, if you have no bleeding for a few consecutive days, it can be a good sign that the treatment was effective. However, if you continue to see blood on the toilet paper or experience discomfort, it’s advisable to follow up with your doctor.

3. When to seek further medical advice?
If the bleeding persists beyond four weeks, increases in volume, or is accompanied by other symptoms such as severe pain, swelling, or changes in bowel habits, you should definitely reach out to your healthcare provider. They may want to perform an examination to rule out complications such as thrombosed hemorrhoids or other issues that may require additional treatment.

4. Post-operative care and prevention of complications:
To aid in your recovery and minimize the risk of complications, consider the following tips:
- Diet: Maintain a high-fiber diet to prevent constipation and straining during bowel movements. This can help reduce pressure on the surgical site.

- Hydration: Drink plenty of fluids to help keep stools soft.

- Avoid Straining: When using the restroom, try to relax and avoid straining, as this can exacerbate bleeding.

- Warm Baths: Soaking in warm baths can help soothe the area and promote healing.

- Follow-Up Appointments: Attend any scheduled follow-up appointments with your healthcare provider to monitor your recovery.

In summary, while some bleeding after hemorrhoid banding can be normal, it’s essential to monitor the situation closely. If you have concerns about the amount of bleeding or other symptoms, don’t hesitate to reach out to your healthcare provider for personalized advice and potential further evaluation. Your health and peace of mind are paramount, and addressing any issues early can help ensure a smoother recovery.

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