Bleeding Frequency After Hemorrhoid Banding Surgery

Frequency of hemorrhoidal bleeding

Hello Dr.
Ke, I have undergone several rubber band ligation procedures, with the last one being in August of last year.
After the ligation, I noticed that my external hemorrhoid has actually increased in size.
During my follow-up visit this month, the doctor mentioned that the internal hemorrhoid ligation was handled quite well.

1.
After the ligation, I have not been passing hard stools, yet I still experience bleeding approximately every two weeks.
The amount of blood is minimal (at most, a half-centimeter circular stain or a small amount of blood that resembles a scrape on the toilet paper).
Should I return for another ligation due to this bleeding frequency? If I apply medication whenever I bleed, is that frequency too high?
2.
The doctor mentioned that the enlargement of my external hemorrhoid could be due to the ligation of the internal hemorrhoid, causing more blood to flow to the external hemorrhoid, resulting in its swelling.
Is this a possible scenario?
3.
My external hemorrhoid does not cause pain, but I experience swelling and a sensation of a foreign body almost daily.
Is surgery the only option for treatment? Would laser or cryotherapy be suitable? There are minimally invasive surgical options proposed by plastic surgeons; can these replace traditional surgery? Thank you.

Hemorrhoid Bleeding Frequency, 30~39 year old female. Ask Date: 2016/01/27

Dr. Ke Fangxu reply Surgery

1.
If the amount of bleeding is not significant, topical medications can be used for treatment.
The National Health Insurance Administration has regulations that rubber band ligation cannot be performed more than four times a year, with each procedure spaced at least two weeks apart, so it should not and does not need to be done too frequently.

2.
It is possible, especially if there are poor bowel habits, the likelihood increases.

3.
If the symptoms are not severe, I personally do not recommend surgery.
Regardless of the surgical method chosen, each has its own risks and discomforts, so the focus should be on the indications for surgery rather than the method or instruments used.

Reply Date: 2016/01/27

More Info

After undergoing hemorrhoid banding surgery, it is not uncommon for patients to experience some degree of bleeding, especially in the weeks following the procedure. Let's address your concerns systematically.

1. Bleeding Frequency and Follow-Up: The bleeding you describe, occurring every two weeks with minimal amounts (like a small blood spot on toilet paper), is not unusual after hemorrhoid banding. This can happen as the tissue heals and the banded hemorrhoid falls off. However, if the bleeding persists or increases in frequency or volume, it is advisable to return to your physician for a follow-up. Continuous bleeding, even if minimal, could indicate that the area is not healing properly or that there may be another underlying issue. Applying topical medications can help manage minor bleeding, but if you find yourself needing to do this frequently, it may warrant further evaluation.

2. External Hemorrhoid Enlargement: It is indeed possible for external hemorrhoids to become more prominent after internal hemorrhoids are banded. When the internal hemorrhoids are treated, the blood flow dynamics in the anal region can change, potentially leading to increased pressure and swelling in the external hemorrhoids. This phenomenon is particularly common in patients with mixed hemorrhoids, where both internal and external hemorrhoids coexist. Your physician's assessment seems accurate, and it is essential to monitor the situation. If the external hemorrhoid continues to enlarge or causes discomfort, further intervention may be necessary.

3. Management of External Hemorrhoids: Since your external hemorrhoid is not painful but is causing a sensation of swelling and discomfort, there are several treatment options available. While surgery is one option, less invasive treatments like laser therapy or cryotherapy (freezing treatment) can also be effective for external hemorrhoids. These methods can reduce swelling and discomfort without the need for a more extensive surgical procedure. It is crucial to discuss these options with your healthcare provider to determine the best course of action based on your specific condition and preferences.

4. Minimally Invasive Surgery: The field of hemorrhoid treatment has evolved, and there are now various minimally invasive techniques available that can replace traditional surgery. These include procedures like stapled hemorrhoidopexy or transanal hemorrhoidal dearterialization (THD). These techniques aim to reduce recovery time and postoperative pain while effectively treating hemorrhoids. Consulting with a colorectal surgeon who specializes in these procedures can provide you with more information on whether you are a suitable candidate for such treatments.

In conclusion, while some bleeding after hemorrhoid banding can be normal, it is essential to keep an open line of communication with your healthcare provider. Regular follow-ups are crucial to ensure that your recovery is progressing as expected and to address any complications that may arise. If you have concerns about the size of your external hemorrhoid or the frequency of bleeding, do not hesitate to seek further medical advice. Your comfort and health are of utmost importance, and there are various treatment options available to help manage your symptoms effectively.

Similar Q&A

Managing Post-Surgical Bleeding After Hemorrhoid Banding: Tips for Recovery

Hello doctor, I recently underwent a rubber band ligation for internal hemorrhoids, and the day after the procedure, the hemorrhoid fell off, resulting in significant bleeding. Upon returning for a follow-up, the doctor said there was no major issue and prescribed me a suppositor...

Dr. Ke Fangxu reply Surgery
After hemorrhoid ligation, it is indeed possible to experience occasional bleeding. As long as there is no continuous heavy bleeding, it is not a concern. However, if the bleeding does not stop, it may require the addition of oral medication or further treatment.

Post-Banding Bleeding After Hemorrhoid Surgery: What to Do?

Hello, over the past week I have experienced bleeding from mixed internal and external hemorrhoids (bright red in the toilet). Yesterday, I underwent a procedure at a nearby major hospital to ligate the internal hemorrhoid and have surgery scheduled for the 14th. This morning, my...

Dr. Zhang Shuhao reply Surgery
After the ligation of internal hemorrhoids, they may undergo ischemia and gradually fall off. The wound after detachment may have a small amount of bleeding, which is normal as long as the amount is not significant, and there is no need for an urgent follow-up. However, if there ...

Post-Surgery Concerns: Increased Bleeding After Hemorrhoid Banding

Hello, Doctor: I underwent a laparoscopic tubal ligation surgery yesterday, but in the two days following the procedure, I have noticed an increase in the amount of blood in my stool. Is it possible that the rubber band was not applied correctly or has fallen off? Prior to the su...

Dr. Ke Fangxu reply Surgery
In the first two days after undergoing rubber band ligation for internal hemorrhoids, there may be an increase in bleeding, which is caused by bleeding from the ligation site. This usually improves within 2-3 days. If the bleeding is significant or persists for more than a week w...

Understanding Post-Surgery Bleeding After Hemorrhoid Surgery

Hello Doctor: I had hemorrhoid surgery five weeks ago, but I am still experiencing intermittent bleeding, which makes me very anxious. I have asked others who have gone through the same procedure, and they were able to return to their normal routines within one to two weeks. Coul...

Dr. Lin Hongmao reply Surgery
Dear Xiao Ting: Frequent irregular bleeding after surgery may be due to incomplete wound healing, constipation, or diarrhea. You may observe for a while longer, but if the situation does not improve, please return for a follow-up appointment so the doctor can assess the issue. Wi...