Post-banding bleeding of internal hemorrhoids?
Hello, over the past week I have experienced bleeding from mixed internal and external hemorrhoids (bright red in the toilet).
Yesterday, I underwent a procedure at a nearby major hospital to ligate the internal hemorrhoid and have surgery scheduled for the 14th.
This morning, my stool was thin and minimal, and there was still bright red blood in the toilet.
After cleaning, I noticed a small blood clot resembling a third of my index finger joint when applying ointment and reinserting the hemorrhoid suppository.
The hemorrhoids and the ligation itself are not painful, but the doctor only prescribed ointment and did not provide any stool softeners or hemostatic agents.
The bleeding stopped after cleaning (it did not drip out).
Should I urgently return for a follow-up? I am 24/25 years old, experiencing anxiety along with high blood pressure, and I am really distressed by the sight of blood.
Thank you.
Nìmíng, 20~29 year old female. Ask Date: 2023/03/03
Dr. Zhang Shuhao reply Surgery
After the ligation of internal hemorrhoids, they may undergo ischemia and gradually fall off.
The wound after detachment may have a small amount of bleeding, which is normal as long as the amount is not significant, and there is no need for an urgent follow-up.
However, if there is heavy bleeding, pain, fever, or other concerning symptoms, it is important to return for a prompt evaluation.
Reply Date: 2023/03/03
More Info
Post-banding bleeding after hemorrhoid surgery can be a concerning issue, especially when you notice bright red blood in the toilet after a bowel movement. It's important to understand that some bleeding can be a normal part of the healing process following hemorrhoid surgery, particularly after procedures like banding, which involves placing a rubber band around the base of the hemorrhoid to cut off its blood supply. However, there are certain signs and symptoms that warrant immediate medical attention.
In your case, since you are experiencing fresh red blood during bowel movements, it is essential to monitor the situation closely. If the bleeding is minimal and stops after cleaning, it may not be a cause for alarm. However, if you notice an increase in the amount of blood, or if the bleeding does not stop, you should seek medical attention promptly. Additionally, if you experience any pain, swelling, or changes in your bowel habits, these could be signs of complications that need to be addressed.
Here are some recommendations for managing your situation:
1. Monitor the Bleeding: Keep track of how much blood you see. If it is just a small amount that stops after cleaning, it may be part of the normal healing process. However, if you see a significant amount of blood or if it continues over the next few days, contact your healthcare provider.
2. Avoid Straining: Straining during bowel movements can exacerbate bleeding. To help prevent this, consider increasing your fiber intake through fruits, vegetables, and whole grains. Staying hydrated is also crucial, as it helps soften the stool.
3. Use Medications as Directed: If your doctor prescribed any topical medications or ointments, use them as directed. While you mentioned that your doctor did not prescribe a stool softener or a hemostatic agent, you might want to discuss this with your healthcare provider, especially if you continue to experience bleeding.
4. Rest and Recovery: Ensure you are getting enough rest and avoiding activities that could put strain on your body. This includes heavy lifting or vigorous exercise until you have fully healed.
5. Follow-Up Appointments: Make sure to attend any scheduled follow-up appointments with your healthcare provider. They can assess your healing process and address any concerns you may have.
6. Emergency Signs: Seek immediate medical attention if you experience any of the following:
- Heavy bleeding that does not stop
- Severe pain that is not controlled by over-the-counter pain medications
- Signs of infection, such as fever, chills, or increased redness and swelling around the surgical site
- Changes in bowel habits, such as severe constipation or diarrhea
In summary, while some bleeding can be expected after hemorrhoid surgery, it is crucial to monitor the situation closely. If you have any doubts or if the bleeding worsens, do not hesitate to reach out to your healthcare provider for guidance. Your health and peace of mind are paramount, and it is always better to err on the side of caution when it comes to post-operative care.
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