Is Pain After Rubber Band Ligation Normal? Post-Procedure Discomfort

Q: Is Pain After Rubber Band Ligation Normal? Post-Procedure Discomfort

Hello： Your original condition is acute thrombosed hemorrhoids. <br>If there is no pain or bleeding, it is generally recommended to use topical ointments for about two weeks, as it will usually resolve on its own. <br>If symptoms do not improve, you can have the thrombus removed

Is it normal to experience persistent pain after the rubber band ligation procedure?

Hello Dr.
Ke,
I had diarrhea for 7 days, and on the 8th day, I had a normal bowel movement.
However, the right side of my anus became swollen.
It doesn't hurt, and there was no blood in my stool, which was of normal color.
On the 9th day, the swelling increased to about the size of a coin.
The stool remained normal in color and without blood, but it hurt when touched.
On the 10th day, I soaked in warm water, and the swelling decreased, but it became very painful with even light touch.
On the 11th day, I saw a doctor who diagnosed me with "one bleeding internal hemorrhoid and mild anal fissure." The doctor immediately recommended rubber band ligation, stating it wouldn't hurt.
However, after the procedure, I experienced intense pain that made my legs shake, and I woke up in the middle of the night due to the pain.
The day after the ligation, I felt pain from vibrations while riding my motorcycle to work.

I would like to ask:
1.
Regarding the rubber band ligation, I read that it shouldn't be painful.
Is my level of pain normal?
2.
I maintain a normal exercise routine and diet, so why did I develop internal hemorrhoids due to diarrhea? Are there any preventive measures I can take?
Thank you for your response, and I wish you good health.

phile, 20~29 year old female. Ask Date: 2009/12/11

Dr. Ke Fangxu reply Surgery

Hello: Your original condition is acute thrombosed hemorrhoids.
If there is no pain or bleeding, it is generally recommended to use topical ointments for about two weeks, as it will usually resolve on its own.
If symptoms do not improve, you can have the thrombus removed in the outpatient clinic under local anesthesia.
Rubber band ligation is indeed typically used for bleeding internal hemorrhoids, but it seems you do not have any bleeding, correct? Rubber band ligation should not be painful; however, if the ligation is not deep enough and contacts the dentate line of the anus, it can cause severe pain, and the rubber band must be removed.
I suggest you return to your original physician for further management.
The formation of hemorrhoids is often related to bowel habits and lifestyle.
Both constipation and diarrhea can exacerbate the condition.
The maintenance strategies are well-known, but if you are experiencing bowel issues, it is advisable to seek medical treatment rather than resorting to unverified home remedies, as they may disrupt your bowel habits.
Dr.
Ke Fang-Hsu, Keelung Hospital, Department of Health.

Reply Date: 2009/12/11

More Info

After undergoing rubber band ligation for hemorrhoids, experiencing pain is not uncommon, although the intensity and duration can vary from person to person. Let's break down your concerns regarding the pain and discomfort following the procedure.

1. Pain After Rubber Band Ligation: While rubber band ligation is generally considered a minimally invasive procedure with a lower pain profile compared to traditional hemorrhoid surgeries, some patients do report discomfort or pain afterward. This can be due to several factors:
- Inflammation: The ligation process can cause localized inflammation in the area, leading to pain and swelling. This is a normal response as your body reacts to the procedure.

- Nerve Sensitivity: The area around the anus is rich in nerve endings, and any procedure can heighten sensitivity temporarily. This may explain why you feel pain upon light touch.

- Post-Procedure Recovery: After the ligation, the tissue around the hemorrhoid may take some time to heal, and during this healing phase, discomfort can be expected. The pain you experienced that caused you to wake up at night is likely part of this healing process.

2. Why Did I Develop Internal Hemorrhoids?: Internal hemorrhoids can develop due to several reasons, and while it may seem surprising that they appeared after experiencing diarrhea, there are a few explanations:
- Increased Pressure: Diarrhea can lead to straining during bowel movements, which increases pressure in the rectal area and can contribute to the formation of hemorrhoids.

- Chronic Constipation or Diarrhea: Both conditions can lead to the development of hemorrhoids. If you have a history of alternating between constipation and diarrhea, this could be a contributing factor.

- Diet and Lifestyle: A diet low in fiber can lead to constipation, which can then cause straining during bowel movements. Ensuring adequate fiber intake can help maintain regular bowel movements and reduce the risk of hemorrhoids.

3. Post-Procedure Care and Maintenance: To promote healing and prevent future occurrences of hemorrhoids, consider the following:
- Diet: Increase your fiber intake through fruits, vegetables, and whole grains. This can help soften stools and reduce straining.

- Hydration: Drink plenty of fluids to help keep your stools soft.

- Regular Exercise: Engage in regular physical activity to promote healthy bowel function.

- Avoid Straining: When using the bathroom, try not to strain. If you feel the urge to go, do so promptly rather than waiting.

- Warm Baths: Soaking in warm water can help relieve discomfort and promote blood flow to the area, aiding in healing.

If your pain persists or worsens, or if you notice any unusual symptoms such as bleeding or severe swelling, it is essential to follow up with your healthcare provider. They can assess your recovery and determine if any additional treatment is necessary.
In summary, while experiencing pain after rubber band ligation can be normal, it is crucial to monitor your symptoms and maintain a healthy lifestyle to prevent further issues. Always consult your healthcare provider for personalized advice and treatment options.

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