Is It Normal to Experience Anal Fissures After Rubber Band Ligation?

Is it normal to still experience bleeding after undergoing a mole excision procedure?

I underwent rubber band ligation for internal hemorrhoids in mid-December, and within about eight days, both the hemorrhoids and the rubber band fell off.
I only experienced bleeding on the first day, and there has been no bleeding since! However, I was quite busy for the past two days and did not have a bowel movement, which resulted in a hard stool today.
Consequently, I suspect I have an anal fissure (based on my previous experiences and information I found online, as I experienced bleeding and pain after the bowel movement).
I would like to know if it is normal to develop an anal fissure after having undergone rubber band ligation for internal hemorrhoids.
Thank you!

Niming, 30~39 year old female. Ask Date: 2015/12/28

Dr. Xu Kaixi reply Surgery

After hemorrhoid surgery, the anal mucosa may develop scar tissue due to wound healing.
This scar tissue has reduced elasticity, making it more susceptible to damage and bleeding from friction with stool.
This is considered a normal phenomenon and will improve over time.

Reply Date: 2015/12/28

More Info

Experiencing anal fissures after undergoing rubber band ligation for hemorrhoids is not uncommon, especially if there have been changes in bowel habits or stool consistency. Rubber band ligation is a common procedure used to treat internal hemorrhoids, and while it can effectively reduce symptoms associated with hemorrhoids, it does not eliminate the possibility of developing anal fissures, particularly if you experience constipation or hard stools.

Anal fissures are small tears in the lining of the anus, often caused by the passage of hard or large stools. When you mentioned that you had a busy period and did not have regular bowel movements, this can lead to harder stools, which can cause trauma to the anal canal during defecation. The pain and bleeding you described after bowel movements are classic symptoms of an anal fissure.
It's important to note that while rubber band ligation can alleviate the symptoms of hemorrhoids, it does not prevent other anal conditions from occurring. Therefore, it is entirely possible to develop an anal fissure even after the ligation procedure. The presence of a fissure can be exacerbated by factors such as dehydration, low fiber intake, and irregular bowel habits.
To manage and prevent further fissures, consider the following recommendations:
1. Increase Fiber Intake: Consuming a diet rich in fiber can help soften stools and promote regular bowel movements. Foods such as fruits, vegetables, whole grains, and legumes are excellent sources of dietary fiber.

2. Stay Hydrated: Drinking plenty of water throughout the day can help prevent constipation and ensure that stools remain soft.

3. Use Stool Softeners: If dietary changes are insufficient, over-the-counter stool softeners may be beneficial in easing bowel movements.

4. Warm Sitz Baths: Taking warm baths can help soothe the anal area and promote healing of fissures.

5. Avoid Straining: When using the bathroom, try to relax and avoid straining, as this can worsen fissures.

6. Consult Your Doctor: If the pain persists or if you notice significant bleeding, it is essential to consult your healthcare provider. They may recommend treatments such as topical anesthetics, nitroglycerin ointment, or other medications to promote healing.

In summary, while it is not unusual to experience anal fissures after rubber band ligation, it is crucial to address the underlying factors contributing to their development. By making dietary adjustments and maintaining regular bowel habits, you can reduce the risk of future fissures and promote overall anal health. If symptoms persist, do not hesitate to seek medical advice for further evaluation and management.

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