Managing Pain After Internal Hemorrhoid Banding: What to Do? - Surgery

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Internal hemorrhoid ligation


Hello Doctor, I would like to ask a question.
Yesterday, on August 17th, I visited the doctor who treated my internal hemorrhoids.
Initially, I only wanted to address the pain and bleeding from an anal fissure, but the doctor went ahead and treated the internal hemorrhoids.
After the procedure, the pain became extremely severe, making it impossible for me to sleep.
I took pain medication, but it did not help.
I would like to ask the doctor how I should handle this situation, as the pain is keeping me awake, and I am very tired and want to sleep.
Thank you for your response.

L, 20~29 year old female. Ask Date: 2023/08/18

Dr. Xu Kaixi reply Surgery


Since the procedure was just completed on August 17, the pain may be a response to the wound.
If taking pain medication does not improve the situation, it is advisable to return to the original treating physician for an examination to rule out any other issues.

Reply Date: 2023/08/18

More Info


Managing pain after an internal hemorrhoid banding procedure can be challenging, especially when the discomfort is severe enough to disrupt sleep and daily activities. It’s important to understand that while some pain is expected after such a procedure, the intensity of your pain should be addressed promptly. Here are some recommendations based on medical knowledge and common practices for managing post-procedural pain:
1. Pain Management: If over-the-counter pain medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are not providing relief, you should contact your healthcare provider. They may prescribe stronger pain medications, such as opioids, for short-term use. However, it’s crucial to use these medications cautiously and under medical supervision due to the risk of dependency and side effects.

2. Cold Compress: Applying a cold compress to the affected area can help reduce swelling and numb the pain. Wrap ice in a cloth and apply it to the anal area for about 15-20 minutes every hour as needed. Be sure not to apply ice directly to the skin to avoid frostbite.

3. Sitz Baths: Taking warm sitz baths can provide significant relief. Fill a bathtub or a basin with warm water and sit in it for 15-20 minutes several times a day. This can help soothe the area, promote blood flow, and reduce discomfort.

4. Dietary Adjustments: To prevent straining during bowel movements, which can exacerbate pain, ensure you are consuming a high-fiber diet. Foods rich in fiber, such as fruits, vegetables, whole grains, and legumes, can help soften stools. Additionally, staying well-hydrated by drinking plenty of water is essential.

5. Avoid Straining: It’s crucial to avoid straining during bowel movements. If you feel constipated, consider using a stool softener or a mild laxative, but consult your doctor before starting any new medication.

6. Rest and Positioning: Rest is vital for recovery. Try to avoid sitting for prolonged periods, as this can increase pressure on the anal area. When sitting, consider using a donut-shaped cushion to relieve pressure.

7. Follow-Up Care: Since your pain is severe and not improving with over-the-counter medications, it’s essential to follow up with your healthcare provider. They may want to evaluate you for any complications, such as infection or excessive swelling, which could require additional treatment.

8. Monitoring Symptoms: Keep track of your symptoms. If you experience fever, increased swelling, or any signs of infection (such as pus or increased redness), seek medical attention immediately.

9. Psychological Support: Severe pain can lead to anxiety and stress, which can further exacerbate the perception of pain. Consider relaxation techniques such as deep breathing, meditation, or gentle yoga to help manage stress levels.

In summary, while some pain is expected after internal hemorrhoid banding, severe pain that disrupts sleep and daily life should not be ignored. Utilize pain management strategies, maintain a high-fiber diet, and ensure proper follow-up care with your healthcare provider. If your pain persists or worsens, do not hesitate to seek further medical evaluation. Your comfort and recovery are paramount, and there are various strategies and treatments available to help manage your pain effectively.

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