Post-Surgery Recovery Issues: Managing Pain and Bleeding After Hemorrhoid Surgery - Surgery

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Postoperative issues?


Hello Dr.
Ke,
I underwent traditional hemorrhoid surgery in June 2015, during which both internal and external hemorrhoids were excised.
However, my recovery has not been satisfactory.
I have a regular bowel movement once a day, but I notice some blood on the stool, particularly at the end.
This occurs even with soft stools, and with hard stools, it is accompanied by pain.
There is no dripping of blood.
I sit in warm water 2 to 3 times daily, but it seems to have little effect.
I also experience anal pain during light exercise.
I am very apprehensive about returning for a follow-up.
After the surgery, I attended three follow-up appointments, and each time the digital examination resulted in bleeding.
Could you please advise me on how to address my post-surgical recovery issues? Thank you.

Jin Yu, 40~49 year old female. Ask Date: 2016/05/21

Dr. Ke Fangxu reply Surgery


Mild bleeding within one month after hemorrhoid surgery is considered normal.
During this period, it is recommended to avoid constipation and to take warm sitz baths frequently.
However, if there is heavy bleeding or if the bleeding lasts longer than one month, it is important to consult a physician for further evaluation and treatment.

Reply Date: 2016/05/21

More Info


After undergoing hemorrhoid surgery, it is not uncommon for patients to experience some discomfort and complications during the recovery process. Your symptoms of bleeding and pain during bowel movements, especially when passing hard stools, are concerning and warrant a closer look.

First and foremost, it is essential to understand that the surgical site can take time to heal, and some bleeding can be expected, particularly if you are experiencing hard stools. The presence of blood on the stool or toilet paper can be indicative of irritation or trauma to the surgical area. Here are some strategies to help manage your recovery and alleviate your symptoms:
1. Dietary Adjustments: A high-fiber diet is crucial for preventing constipation and ensuring softer stools. Incorporate plenty of fruits, vegetables, whole grains, and legumes into your meals. Additionally, consider using a fiber supplement if you struggle to get enough fiber from food alone. Staying well-hydrated by drinking plenty of water is also essential.

2. Stool Softeners: Over-the-counter stool softeners can be beneficial in easing the passage of stools and reducing strain during bowel movements. These medications can help prevent hard stools, which can exacerbate pain and bleeding.

3. Warm Sitz Baths: You mentioned that you are already taking warm sitz baths 2-3 times a day. This practice can help soothe the area, reduce inflammation, and promote healing. Ensure that the water is warm but not hot, and consider adding Epsom salts for additional relief.

4. Pain Management: If you are experiencing significant pain, over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage discomfort. However, consult your healthcare provider before taking any medication to ensure it is appropriate for your situation.

5. Avoid Straining: It is crucial to avoid straining during bowel movements, as this can lead to further irritation and bleeding. If you feel the urge to push, try to relax and allow your body to do the work naturally. If you are having difficulty, consider using a stool softener or laxative as needed.

6. Follow-Up Care: Since you have experienced bleeding during follow-up visits, it is essential to communicate these symptoms to your healthcare provider. They may want to perform a more thorough examination to ensure there are no complications, such as infection or excessive scar tissue formation. It is understandable to feel apprehensive about follow-up appointments, but they are crucial for monitoring your recovery.

7. Physical Activity: While light exercise can be beneficial for overall health, be cautious with activities that put pressure on the pelvic area. Gradually increase your activity level as tolerated, but avoid heavy lifting or strenuous exercises until you have fully healed.

8. Monitor Symptoms: Keep track of your symptoms, including the frequency and amount of bleeding, pain levels, and any changes in bowel habits. This information will be helpful for your healthcare provider in assessing your recovery.

9. Consider Professional Help: If your symptoms persist or worsen, it may be necessary to consult a specialist, such as a colorectal surgeon, for further evaluation. They can provide additional treatment options or interventions if needed.

In summary, while some discomfort and bleeding can be part of the recovery process after hemorrhoid surgery, it is essential to manage your symptoms proactively. By making dietary changes, using stool softeners, and maintaining open communication with your healthcare provider, you can work towards a smoother recovery. If you have any concerns or if your symptoms do not improve, do not hesitate to seek further medical advice. Your health and comfort are paramount, and addressing these issues early can help prevent more significant complications down the line.

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