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Applied Single Rubber Band For Hemorrhoid. Noticed Blood During Bowel Movement. Is This Normal?

Posted on Sun, 8 Dec 2013

Question: My son was applied a single rubber band for his hemorrhoid six days ago.He passes blood whenever he opens his bowel as usual although the quantity is probably less often. His haemoglobin was earlier 16.4 gm before and heis passes blood for last 60 days and it has reduced to 9.4 gm

Answered by Dr. Deepak Kishore Kaltari (4 hours later)

Brief Answer: Little bleeding quite common after banding Detailed Answer: Namaste Welcome to Healthcare-Magic Greetings of the day Rubber band is Applied to the pedicle of the hemorrhoid near the base. The hemorrhoid undergoes avascular necrosis due to disruption of blood supply, it sloughs out and passed out over the next week. This usually presents with little bleeding. Some amount of bleeding is an expected sequelae following hemorrhoid banding and there is no cause of concern. Rest be assured everything is alright if the amount of bleeding is not too much and there is no significant pain. Of concern is low hemoglobin and it needs to be treated. I hope it helped. Wishing your son a speedy recovery. Do get back to me if you have any other query. Take care Regards Dr Deepak XXXXXXX Consultant Surgeon

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Kishore Kaltari (59 minutes later)

Thank you very much for your reply.Regarding bleeding I have forgotton to point out that since the day of banding, no significant change in the bleeding has been observed.After a week's bleeding is easily acceptable but same type of bleeding is probably difficult to understand even after a treatment.Do you see any problem in it or not? If you feel as an expert that it normally happens like that then it will be reassuring for us.As it was first degree internal hemorrhoids so the treating doctor has told us for a review after a weeks time and then he may consider Injection Therapy.We would be happy to know from you as an expert about his management of hemorrhoids.We are using Iron and other measures for his loss of hemoglobin.

Answered by Dr. Deepak Kishore Kaltari (45 minutes later)

Brief Answer: no cause for concern Detailed Answer: Namaste Greetings I hope your son is on adequate stool softening laxatives,as constipation may be cause of bleeding. I suggest plenty of oral fluids, high fiber diet and laxatives. If the bleeding is less than a gauge piece there seems to be no cause of worry. Do get a thorough out patient proctoscopy from your surgeon to know everything is alright with banding. I hope it helped Take care Regards Dr Deepak

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepak Kishore Kaltari (1 hour later)

Thank you again.My son had no constipstion at all neither these days nor in the past.He is also taking Cremaffine for last 3 weeks.He had undergone proctoscopy 3 times and Limited Left Colonoscopy.Colon was seen upto mid transverse colon.Every part was absolutely fine and on probing only the endoscopist could detect point of bleeding and to him it seemedto be 2nd degree internal hemorrhoids.But the doctor who did banding it was 1st degree hemorrhoids.Therefore, he told me that single band was applied and if required he will go for Injection Therapy .I am worried due to fall in level of Hb4.If it persists it will tell upon his general health and that I am sure you too will agree to the adverse consequences

Answered by Dr. Deepak Kishore Kaltari (11 minutes later)

Brief Answer: fall in hemoglobin from baseline significant Detailed Answer: Namaste Welcome to Healthcare-Magic Greetings of the day I hope the surgeon who did endoscopy and found out a bleeding point has done something for the bleeding that is cauterization for bleeding point. Even a small bleeding point from rectal mucosa is notorious, hence achieving complete hemostasis for stopping the bleeding is important. Drop in hemoglobin of more than 1.5gm% than the previous baseline hemoglobin is significant. Suggest you to see the operating surgeon, and proceed with injection sclerotherapy if there is no active infection. This will definitely control the bleeding. Wishing your son a speedy recovery Take care Regards Deepak

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Above answer was peer-reviewed by : Dr. Yogesh D