Post-Surgery Care and Pain Management for Thrombosed External Hemorrhoids - Surgery

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Postoperative care for thrombosed external hemorrhoids?


Hello Doctor, I underwent an outpatient procedure for a thrombosed external hemorrhoid yesterday (approximately the size of an almond, and the surgery was performed when there was no pain).
After the blood clot was removed, the doctor also performed a procedure to ligate the excess skin.
However, today I have been very uncomfortable sitting and standing, experiencing significant pain, and I feel that the area around the external hemorrhoid is swollen.
Is this a normal part of the healing process? Also, is it normal to feel a stinging discomfort when applying the ointment? Thank you, Doctor.

T34, 30~39 year old female. Ask Date: 2016/08/02

Dr. Ke Fangxu reply Surgery


Thrombosed external hemorrhoids can be effectively relieved through thrombectomy, which alleviates symptoms and accelerates recovery.
However, ligation of external hemorrhoidal tags tends to be more uncomfortable, and it is less commonly performed by specialists due to the significant discomfort, pain, swelling, and inflammation that may arise.
At this stage, topical treatments can only be applied to alleviate symptoms.
If the results are unsatisfactory, oral medication may be necessary, and frequent sitz baths can also provide relief.
Generally, it takes one to two weeks for symptoms to improve.

Reply Date: 2016/08/02

More Info


Post-surgery care and pain management for thrombosed external hemorrhoids can be challenging, especially after a procedure that involves the removal of a blood clot and possibly the excision of excess skin. It’s important to understand that some discomfort and swelling can be expected in the days following the surgery, but there are effective ways to manage pain and promote healing.

Firstly, it’s normal to experience increased pain and swelling after the procedure. The surgical site is likely to be inflamed as your body responds to the trauma of surgery. The pain you are feeling, especially if it is significant, can be attributed to the surgical manipulation of tissues and the healing process. Typically, pain should gradually decrease over the course of a few days to a week. However, if the pain is severe or worsening, it is crucial to contact your healthcare provider for further evaluation.

In terms of pain management, over-the-counter pain relievers such as acetaminophen or ibuprofen can be helpful. These medications can reduce pain and inflammation. If your doctor prescribed stronger pain medications, make sure to take them as directed. Additionally, applying ice packs to the area for 15-20 minutes at a time can help reduce swelling and numb the pain.

Regarding the use of topical medications like the ointment you mentioned (likely a topical anesthetic or a steroid cream), it is not uncommon to experience a stinging or burning sensation upon application. This can be due to the sensitivity of the skin in the area post-surgery. If the discomfort is too intense or persists, you should discuss this with your doctor, as they may recommend an alternative treatment or a different application method.

Sitz baths can also be beneficial. Soaking in warm water several times a day can help soothe the area, promote blood flow, and aid in the healing process. Ensure that the water is warm but not hot, as excessive heat can exacerbate swelling.

As for the swelling you are experiencing, some degree of swelling is expected after surgery. However, if you notice significant swelling, redness, or if the area feels warm to the touch, these could be signs of infection, and you should seek medical attention promptly.
In summary, while some pain and swelling are normal after surgery for thrombosed external hemorrhoids, effective pain management strategies and proper post-operative care are essential for recovery. If your symptoms do not improve or worsen, do not hesitate to reach out to your healthcare provider for further guidance. They can provide personalized recommendations based on your specific situation and ensure that your recovery is on track.

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