Is Bleeding After Rubber Band Ligation for Hemorrhoids Normal?

Post-banding bleeding of internal hemorrhoids?

Hello, Dr.
Ke.
I would like to ask, after undergoing rubber band ligation for hemorrhoids one month ago, I have had no discomfort.
However, these past few days, after using the restroom, I noticed that when I wiped a bit harder, there was a small amount of blood on the toilet paper.
I would like to know if this is abnormal.

Yan, 40~49 year old female. Ask Date: 2024/07/02

Dr. Ke Fangxu reply Surgery

One month after rubber band ligation for hemorrhoids, the wound should have healed.
At this point, any bleeding may be due to bleeding from other locations of internal hemorrhoids.
As long as the amount of bleeding is not significant, it is not a concern; otherwise, it is advisable to consult a physician for examination or medication treatment.

Reply Date: 2024/07/02

More Info

After undergoing rubber band ligation for hemorrhoids, it's not uncommon to experience some bleeding, especially in the days or weeks following the procedure. The ligation process involves placing a rubber band around the base of the hemorrhoid, which cuts off its blood supply. This causes the hemorrhoid to shrink and eventually fall off. However, the surrounding tissue can be sensitive, and minor bleeding can occur as the area heals.

In your case, since you mentioned that you have been experiencing some blood on the toilet paper after cleaning, it is essential to consider a few factors:
1. Timing: You mentioned that it has been about a month since the procedure. Typically, any significant bleeding should have subsided by this time. Light spotting or minor bleeding can occur, especially if there is irritation or if you have been cleaning the area more vigorously than usual.

2. Irritation: If you are using more force than necessary while cleaning, this could irritate the sensitive tissue around the surgical site, leading to minor bleeding. It's crucial to be gentle during this period to avoid aggravating the area.

3. Signs of Complications: While minor bleeding can be normal, you should be vigilant for signs of complications. If you notice bright red blood, especially if it is more than just a few drops, or if you experience increased pain, swelling, or any signs of infection (such as fever or discharge), you should contact your healthcare provider immediately.

4. Follow-Up Care: It’s advisable to have a follow-up appointment with your doctor to ensure that the healing process is progressing as expected. They can assess the area and provide guidance on proper care and what to expect during recovery.

5. Post-Procedure Care: After rubber band ligation, patients are often advised to maintain a high-fiber diet, stay hydrated, and possibly use stool softeners to prevent straining during bowel movements. Straining can lead to increased pressure in the anal area and may contribute to bleeding.

In conclusion, while some light bleeding can be normal after rubber band ligation, it is essential to monitor the situation closely. If the bleeding persists, increases, or is accompanied by other concerning symptoms, it is crucial to seek medical attention. Your healthcare provider can provide the best guidance tailored to your specific situation and ensure that your recovery is on track.

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