Postoperative care for thrombosed internal and external hemorrhoids?
Hello, Dr.
Ke! I would like to ask you...
It has been 23 days since my surgery for thrombosed external and internal hemorrhoids, but I still notice bright red blood when I have a bowel movement, and there seems to be quite a bit of it.
Is this normal? I also have irritable bowel syndrome, which causes me to have at least 4 bowel movements a day, and sometimes even 7 to 8 times.
Could this affect the healing of the wound?
Lin, 20~29 year old female. Ask Date: 2016/06/02
Dr. Ke Fangxu reply Surgery
Two weeks after hemorrhoid surgery, the amount of bleeding should significantly decrease.
Based on your description, it does seem abnormal.
However, if you are having many bowel movements each day, it can indeed affect wound healing.
I recommend that you take medication for irritable bowel syndrome for a period of time; otherwise, the surgical wound may take longer to heal, leading to continued bleeding.
Reply Date: 2016/06/02
More Info
After undergoing surgery for thrombosed hemorrhoids, it is not uncommon to experience some bleeding, especially in the initial weeks following the procedure. However, the presence of bright red blood during bowel movements, particularly if it is significant in quantity, warrants careful consideration and possibly further evaluation by your healthcare provider.
Understanding Post-Surgical Bleeding
1. Normal vs. Abnormal Bleeding:
- Normal: Light spotting or minor bleeding can be expected after hemorrhoid surgery, especially if the surgical site is still healing. This is particularly true if you are experiencing constipation or straining during bowel movements.
- Abnormal: If you notice a substantial amount of bright red blood, it could indicate that the surgical site is not healing properly, or there may be other complications such as a re-bleed or infection.
2. Factors Influencing Healing:
- Your condition of irritable bowel syndrome (IBS) can complicate matters. Frequent bowel movements (4 to 8 times a day) can lead to increased strain and irritation of the surgical site, potentially affecting healing. Straining can cause the stitches to pull apart or lead to further bleeding.
Recommendations for Management
1. Dietary Adjustments:
- Focus on a high-fiber diet to help soften stools and reduce straining. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also crucial.
- Consider using stool softeners or fiber supplements if dietary changes alone do not alleviate constipation.
2. Gentle Bowel Movements:
- Avoid straining during bowel movements. If you feel the urge to go, try to relax and allow your body to do its work naturally. If you are having difficulty, it may be helpful to use a footstool to elevate your feet while sitting on the toilet, which can help facilitate easier bowel movements.
3. Monitoring Symptoms:
- Keep a close eye on the amount and color of the blood. If the bleeding persists, increases, or is accompanied by other symptoms such as severe pain, fever, or signs of infection (like increased redness or swelling), seek medical attention promptly.
4. Follow-Up Care:
- Schedule a follow-up appointment with your surgeon or healthcare provider. They may want to examine the surgical site to ensure that it is healing properly and to rule out any complications.
5. Avoiding Irritants:
- It is advisable to avoid spicy foods, caffeine, and alcohol, as these can exacerbate IBS symptoms and potentially irritate the bowel.
6. Pain Management:
- If you are experiencing pain, over-the-counter pain relievers such as acetaminophen or ibuprofen can help. However, consult your doctor before taking any medication, especially if you are on other treatments.
Conclusion
In summary, while some bleeding can be expected after hemorrhoid surgery, significant amounts of bright red blood should not be overlooked. Your IBS may contribute to the frequency of bowel movements and strain, which can impact healing. It is essential to adopt dietary changes, monitor your symptoms closely, and maintain open communication with your healthcare provider to ensure a smooth recovery. If you have any concerns or if your symptoms worsen, do not hesitate to seek medical advice.
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