Managing Pain After Hemorrhoid Ligation: Tips for a Better Night's Sleep

Q: Managing Pain After Hemorrhoid Ligation: Tips for a Better Night's Sleep

Hello： In response to your questions. 1. Generally, hemorrhoid ligation should not be painful. If there is severe pain, it is usually due to the ligation affecting an external hemorrhoid. If the pain does not subside, you should consult the original physician

On the first night after hemorrhoid banding, the pain was unbearable, making it difficult to sleep?

After my examination at the hospital, I was diagnosed with one internal hemorrhoid and one external hemorrhoid.
The doctor said that the external hemorrhoid is not a concern, but the internal hemorrhoid can be treated with ligation.
After the ligation, he mentioned that part of the external hemorrhoid might have been tied off, which could potentially cause swelling, although it may not happen, as it varies from person to person.
That night after the procedure, I had two bowel movements, both of which were small soft stools, but the quantity was still considerable (the doctor prescribed Laxative Granules for softening the stool).
There were no significant issues with bowel movements, but the internal hemorrhoid slightly protruded, which I was able to push back in without much pain.
However, during the night, I experienced unbearable pain, making it difficult to sleep.
The anti-inflammatory medication prescribed by the doctor was to be taken three times a day and did not include a nighttime pain reliever.
Due to the intense pain and difficulty falling asleep, around 3:30 AM, I drank a cup of oatmeal to coat my stomach before taking the medication (as I did not want to take the medication on an empty stomach).
After taking the medication, I was able to sleep better, but I woke up at 8 AM in pain again, thinking that perhaps the medication's effect had worn off.
Question 1: I wonder if my inability to sleep due to pain is because I am overly sensitive to pain, or if it is due to the swelling of the part of the external hemorrhoid that was tied off, as the doctor mentioned? Since the doctor did not prescribe a nighttime pain reliever, can I take the medication prescribed for three meals before bedtime, or should I consult my attending physician again? Is it too soon to do so, considering it has only been a day?
Question 2: My grandmother passed away from colon cancer at around 70 years old.
Is it possible that I have a hereditary genetic predisposition to colon cancer, especially since I am prone to constipation?
I would appreciate the doctor's answers to these questions.
Thank you!

Dai Dai Hou, 20~29 year old female. Ask Date: 2006/10/18

Dr. Ke Fangxu reply Surgery

Hello: In response to your questions.

1.
Generally, hemorrhoid ligation should not be painful.
If there is severe pain, it is usually due to the ligation affecting an external hemorrhoid.
If the pain does not subside, you should consult the original physician for further management.
2.
If there is a family history of colorectal cancer, the likelihood of other family members developing it increases by twofold.
The general incidence rate is 20 per 100,000, so your risk would be 40 per 100,000, which is not something to be overly concerned about.

Reply Date: 2006/10/18

More Info

Managing pain after hemorrhoid ligation can be challenging, especially when it interferes with your ability to sleep. Here are some strategies to help alleviate discomfort and improve your sleep quality following the procedure.

Understanding Your Pain
After hemorrhoid ligation, it is common to experience pain and discomfort, particularly if the procedure involved ligating part of an external hemorrhoid. The pain you are experiencing could be due to several factors:
1. Post-Operative Pain: This is expected after any surgical procedure, including ligation. The area may be inflamed, and the pain can be exacerbated by bowel movements, even if they are soft.

2. Fear of Pain: Anxiety about pain can heighten your perception of discomfort. This is a psychological component that can make it harder to relax and fall asleep.

3. Inflammation: If the ligation affected the external hemorrhoid, swelling could contribute to your pain levels.

Pain Management Strategies
1. Medication: Since your doctor prescribed anti-inflammatory medication to be taken three times a day, it’s crucial to follow this regimen. However, if you are experiencing significant pain at night, you should consult your doctor about the possibility of taking your medication closer to bedtime. Some patients find that taking their medication right before bed can help manage pain during the night.

2. Over-the-Counter Pain Relievers: If your doctor approves, you might consider taking over-the-counter pain relievers, such as acetaminophen or ibuprofen, before bed to help manage pain. Always consult with your healthcare provider before adding any new medications.

3. Dietary Adjustments: Since you are already taking a stool softener, ensure you are also consuming a high-fiber diet and staying well-hydrated. This can help prevent constipation and reduce strain during bowel movements, which can aggravate hemorrhoid pain.

4. Warm Baths: Soaking in a warm bath can provide relief from pain and discomfort. This can help relax the muscles around the anal area and reduce inflammation.

5. Positioning: Finding a comfortable sleeping position can also help. Some people find relief by sleeping on their side with a pillow between their legs or using a donut-shaped pillow to relieve pressure on the affected area.

6. Relaxation Techniques: Techniques such as deep breathing, meditation, or gentle yoga can help reduce anxiety and promote relaxation, making it easier to fall asleep despite discomfort.

Follow-Up Care
Given that you are experiencing significant pain, it is advisable to follow up with your healthcare provider sooner rather than later. They can assess whether the pain is within the normal range of post-operative discomfort or if there are complications that need to be addressed.

Family History and Cancer Concerns
Regarding your concern about a family history of colorectal cancer, it is understandable to be worried, especially with a history of constipation. While having a family history can increase your risk, it does not guarantee that you will develop the disease. It is essential to maintain regular screenings, especially if you have risk factors such as a family history of colorectal cancer or persistent changes in bowel habits. Discuss your concerns with your healthcare provider, who may recommend a screening schedule based on your family history and personal health.

Conclusion
In summary, managing pain after hemorrhoid ligation involves a combination of medication, dietary adjustments, relaxation techniques, and possibly follow-up care. It is crucial to communicate openly with your healthcare provider about your pain levels and any concerns you may have regarding your health history. By taking proactive steps, you can improve your comfort and sleep quality during your recovery.

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