Pain After Rubber Band Ligation for Hemorrhoids - Surgery

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Rubber band ligation surgery


I just underwent rubber band ligation for internal hemorrhoids, and the pain is extremely intense.
It lasted for about an hour, and I was sweating from the pain.
Is this normal, or does it indicate a failure? I read that it shouldn't be painful...
Also, will it be this painful every time I have the procedure? I still have two more hemorrhoids to address.
Additionally, the doctor mentioned not treating the external hemorrhoids.
Why is that? My doctor didn't explain the reason, and after receiving my medication, I immediately took an anti-inflammatory pain reliever, but the effect was slow.
An hour later, I took another painkiller, which gradually alleviated the pain.

Denna, 30~39 year old female. Ask Date: 2024/01/09

Dr. Ke Fangxu reply Surgery


The rubber band ligation procedure for internal hemorrhoids is theoretically painless; however, if the ligation is too superficial, pain may occur.
If oral medication can alleviate the pain, then pharmacological treatment should be used.
If that is ineffective, the rubber band must be removed.

Reply Date: 2024/01/09

More Info


Experiencing pain after rubber band ligation for hemorrhoids is not uncommon, and your symptoms can be understood in the context of the procedure and its effects on the body. Rubber band ligation is a minimally invasive procedure used to treat hemorrhoids, particularly internal hemorrhoids. During this procedure, a rubber band is placed around the base of the hemorrhoid, cutting off its blood supply. This causes the hemorrhoid to shrink and eventually fall off within a week or so.
The pain you experienced immediately after the procedure, especially if it was intense enough to cause sweating, can be attributed to several factors. First, the ligation itself can cause irritation and inflammation in the surrounding tissues, leading to pain. The procedure can also stimulate nerve endings in the area, which may result in acute pain sensations. While many patients report mild discomfort, some may experience more significant pain, especially in the first few hours post-procedure.
It is essential to recognize that pain levels can vary widely among individuals. Some patients may experience minimal discomfort, while others may have more pronounced pain. The pain typically subsides within a few days as the body begins to heal. If you find that the pain is severe or persists beyond a few days, it is crucial to follow up with your healthcare provider to rule out any complications, such as infection or excessive swelling.

Regarding your question about whether every rubber band ligation will result in such pain, the answer is that experiences can differ. Some patients may have a similar experience with each procedure, while others may find subsequent procedures to be less painful. Factors such as the size and location of the hemorrhoids, individual pain tolerance, and the technique used by the physician can all influence the level of discomfort experienced.

As for your concern about the external hemorrhoids, it is not uncommon for doctors to recommend not treating external hemorrhoids with rubber band ligation. This is because external hemorrhoids are typically covered by skin, and ligation can lead to more pain and complications compared to treating internal hemorrhoids. External hemorrhoids can often be managed with conservative measures such as dietary changes, topical treatments, and pain relief medications. If external hemorrhoids are causing significant discomfort or complications, other treatment options may be considered, such as excision or sclerotherapy.

In your case, it seems that taking anti-inflammatory and pain relief medications helped alleviate the pain over time. It is advisable to follow your doctor's recommendations regarding medication and to communicate any concerns about your pain levels or the effectiveness of your pain management strategy.
In summary, while experiencing significant pain after rubber band ligation can be distressing, it is not necessarily indicative of a failed procedure. Pain levels can vary, and it is essential to monitor your symptoms and maintain open communication with your healthcare provider. If you have further questions or concerns about your recovery or the treatment of your hemorrhoids, do not hesitate to reach out to your doctor for personalized advice and support.

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