Post-Surgery Anal Fistula Pain: Is It Normal After 70 Days?

Pain 70 days after fistula surgery?

Hello, doctor.
It has been 70 days since my anal fistula surgery, and the external wound has healed.
Two days ago, I ate a steamed bun, and my stool was too hard, making it difficult to pass, but there was no bleeding.
After that, I started to experience mild pain in the anal area.
This morning, when I leaned back in my chair, the pain persisted, but it improved a bit in the afternoon.
Is this normal? Is it a recurrence, or could it be a new fistula?

KEVIN, 30~39 year old female. Ask Date: 2016/04/15

Dr. Ke Fangxu reply Surgery

As long as there is no recurrence of swelling or the presence of purulent discharge from an open skin lesion, it is not considered a recurrence or a new fistula.
Mild pain caused by scar tissue after surgery is a normal occurrence; however, it is important to avoid constipation.
If symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2016/04/15

More Info

After undergoing anal fistula surgery, experiencing pain 70 days post-operation can be concerning, but it is not uncommon. The healing process for anal surgeries can be complex, and while the external wound may have healed, internal healing can take longer and may still be sensitive.
Firstly, it’s important to understand that the anal region is highly sensitive, and any changes in bowel habits, such as having hard stools, can lead to discomfort. The fact that you experienced hard stools and some difficulty during bowel movements could have contributed to the pain you are feeling. Straining during bowel movements can put pressure on the surgical site and surrounding tissues, leading to temporary discomfort or pain.
The pain you describe, especially when sitting back against a chair, may be a sign of irritation in the area rather than a recurrence of the fistula or the formation of a new one. It is also possible that the pain is related to muscle tension or spasms in the anal sphincter, which can occur after surgery as the body adjusts and heals.
In terms of whether this is a sign of a recurrence or a new fistula, it is essential to monitor the symptoms closely. If the pain persists, worsens, or is accompanied by other symptoms such as bleeding, swelling, or discharge, it would be prudent to consult your surgeon or a gastroenterologist for a thorough evaluation. They may perform a physical examination or imaging studies to rule out any complications.

Additionally, managing your bowel movements is crucial during the recovery phase. Ensuring that your stools remain soft can help minimize discomfort. This can be achieved through dietary adjustments, such as increasing fiber intake, staying well-hydrated, and possibly using stool softeners if recommended by your healthcare provider.
In summary, while some discomfort can be expected after anal fistula surgery, especially in the context of hard stools and changes in bowel habits, persistent or severe pain should be evaluated by a healthcare professional. It is always better to err on the side of caution and seek medical advice if you have concerns about your recovery. Your surgeon can provide the best guidance tailored to your specific situation and help ensure that your healing process continues smoothly.

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