Blood Streaks in Stool After Hemorrhoid Surgery: Is It Normal?

Blood in the stool?

Hello Dr.
Ke, I am in the fourth stage of mixed hemorrhoids and have had surgery two months ago.
I no longer experience bleeding during bowel movements as I did before, but I do see long streaks of blood on the stool, and there is a bit of pink blood on the toilet paper.
Is this normal? I have bowel movements 1-2 times a day, my weight is normal, my appetite is good, and I do not have any abdominal pain.
Please help me with this, thank you!

Niming, 50~59 year old female. Ask Date: 2016/05/11

Dr. Ke Fangxu reply Surgery

Typically, two months after surgery, the wound should be completely healed, and there should not be any bleeding.
If bleeding occurs at this stage, there are two possible reasons: one is that residual hemorrhoidal tissue may cause slight bleeding due to straining during bowel movements, and the other is bleeding from a higher gastrointestinal lesion.
If it is the former, there is no need for excessive concern; improving bowel habits should suffice.
However, if it is the latter, a colonoscopy is necessary to determine the cause.
If a colonoscopy was performed prior to the surgery, it may not be a concern.
If it has not been done, it would be advisable to take this opportunity to undergo the examination.

Reply Date: 2016/05/11

More Info

After undergoing hemorrhoid surgery, it is not uncommon for patients to experience some bleeding during bowel movements, especially in the weeks and months following the procedure. In your case, seeing blood streaks in your stool and some pinkish blood on toilet paper two months post-surgery can be concerning, but it may not necessarily indicate a serious problem.

Firstly, it is important to understand that hemorrhoid surgery, particularly for advanced cases like fourth-degree hemorrhoids, can lead to changes in the anal and rectal tissues. These changes can include inflammation, irritation, or even minor trauma to the surgical site, which may result in some bleeding. The blood you are observing could be due to several factors:
1. Healing Process: The surgical site is still healing, and minor bleeding can occur as the tissues continue to recover. This is especially true if you are experiencing any straining during bowel movements.

2. Anal Fissures: Sometimes, the surgery can lead to the development of anal fissures, which are small tears in the lining of the anus. These can cause bleeding and discomfort, particularly during bowel movements.

3. Residual Hemorrhoidal Tissue: In some cases, if the hemorrhoids were not completely removed or if new hemorrhoidal tissue has developed, this could also lead to bleeding.

4. Diet and Bowel Habits: If your diet lacks sufficient fiber, it can lead to harder stools, which may cause straining and result in bleeding. Ensuring you have a diet rich in fiber and staying well-hydrated can help prevent this.

Given that you mentioned you are not experiencing pain, your appetite is normal, and you are having regular bowel movements, these are positive signs. However, it is crucial to monitor the situation closely. Here are some recommendations:
- Consult Your Surgeon: It is always best to follow up with your surgeon or healthcare provider regarding any post-operative concerns. They can assess whether the bleeding is within the normal range or if further evaluation is needed.

- Maintain a High-Fiber Diet: Incorporate plenty of fruits, vegetables, and whole grains into your diet to promote softer stools and reduce the risk of straining during bowel movements.

- Stay Hydrated: Drinking plenty of water can also help keep your stools soft.

- Avoid Straining: If you feel the urge to go, try not to delay it, as this can lead to straining.

- Monitor Symptoms: Keep an eye on the amount of blood and any changes in your symptoms. If you notice an increase in bleeding, pain, or any other concerning symptoms, seek medical attention promptly.

In conclusion, while some bleeding can be normal after hemorrhoid surgery, it is essential to stay vigilant and consult with your healthcare provider to ensure that your recovery is on track and to rule out any complications. Your health and comfort are paramount, and addressing any concerns early can lead to better outcomes.

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