Is It Normal to Develop External Hemorrhoids After Internal Ligation? - Surgery

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After undergoing an internal hemorrhoid ligation, it is not uncommon for patients to experience various complications, including the development of external hemorrhoids. The situation you describe, where a new, painful lump has appeared near the anal area, can be concerning but may not necessarily indicate a failure of the procedure.


Understanding Hemorrhoids and Ligation
Hemorrhoids are swollen veins in the lower rectum and anus, and they can be classified as either internal or external. Internal hemorrhoids are located inside the rectum and are usually not visible, while external hemorrhoids are located under the skin around the anus and can be seen and felt. The ligation procedure involves placing a rubber band around the base of the internal hemorrhoid to cut off its blood supply, leading to its eventual shrinkage and detachment.


Possible Reasons for New Symptoms
1. Postoperative Swelling: After ligation, it is common to experience swelling and discomfort in the anal area. This can sometimes lead to the formation of a new external hemorrhoid, especially if there was significant straining during bowel movements or if the area was irritated during the healing process.

2. Thrombosed External Hemorrhoid: The lump you describe could be a thrombosed external hemorrhoid, which occurs when a blood clot forms in an external hemorrhoid. This can be very painful and may require treatment, especially if it does not resolve on its own.

3. Infection or Complications: While less common, there is a possibility of infection or other complications following the ligation. Signs of infection may include increased redness, swelling, discharge, or fever.

4. Normal Healing Process: It’s also important to consider that the healing process can vary significantly from person to person. Some patients may experience more pronounced symptoms as their body adjusts to the changes after the procedure.


Recommendations
- Consult Your Doctor: It is crucial to follow up with your healthcare provider, especially since you are experiencing significant pain and mobility issues. They can assess the new lump, determine whether it is a new hemorrhoid or another issue, and recommend appropriate treatment.

- Pain Management: In the meantime, continue using warm sitz baths to alleviate discomfort. Over-the-counter pain relievers may also help manage pain and inflammation.

- Avoid Straining: Ensure that you are not straining during bowel movements, as this can exacerbate hemorrhoid symptoms. A high-fiber diet and adequate hydration can help keep stools soft and reduce the need for straining.

- Monitor Symptoms: Keep an eye on your symptoms. If you notice any signs of infection or if the pain worsens, seek medical attention promptly.


Conclusion
While the development of a new lump after internal hemorrhoid ligation can be alarming, it is not necessarily indicative of a failed procedure. Various factors, including normal postoperative changes, can contribute to this situation. It is essential to communicate openly with your healthcare provider about your symptoms and concerns to receive the best possible care. Remember, seeking help is a proactive step towards your recovery and overall health.