Post-Surgery Anal Pain When Standing: Causes and Remedies Explained

Postoperative pain while standing after hemorrhoid surgery?

Hello, Director Ke! Two weeks ago, I underwent a repair surgery for rectal prolapse, and upon the doctor's recommendation, I had both internal and external hemorrhoids removed (the hemorrhoids had not shown any symptoms of swelling or pain).
I received local anesthesia and the excision was performed with a scalpel.
Since the surgery, the pain has gradually decreased.
Strangely, I do not experience any pain while lying down, sitting, or walking, but I start to feel a sharp pain near the anus if I stand still for less than a minute.
I am unsure what the reason for this is.

Additionally, my attending physician prescribed me one suppository of Yizhi Kang per day.
Yesterday, I asked my husband to buy another box for me, and I changed it to one in the morning and one in the evening.
Is this acceptable? Also, a previous doctor prescribed me Baizhi Ning ointment for use when I feel discomfort.
Since I haven't felt any discomfort, I haven't used it.
Can I use it now? Thank you!

Shu Mei, 60~69 year old female. Ask Date: 2016/10/09

Dr. Ke Fangxu reply Surgery

It is normal to feel more pain while standing because the sphincter muscle contracts to resist gravity.
It is recommended that you take pain relief medication and use topical ointments, as well as take warm sitz baths, which should effectively alleviate the pain.
During periods of pain, it is acceptable to increase the frequency of suppository use, up to a maximum of three times a day.
Using it in conjunction with topical ointments will enhance the effectiveness.

Reply Date: 2016/10/09

More Info

Post-surgery anal pain, particularly after procedures such as rectal prolapse repair and hemorrhoidectomy, can be a common issue. In your case, experiencing pain specifically when standing can be attributed to several factors related to the surgical procedure and the healing process.

Causes of Pain When Standing
1. Surgical Trauma: The surgical site is still healing, and standing may put pressure on the area that is sensitive and inflamed. The tissues around the rectum and anus are delicate, and any strain can lead to discomfort.

2. Muscle Tension: When standing, the muscles in the pelvic floor may tense up, especially if there is anxiety about pain or discomfort. This tension can exacerbate any existing pain.

3. Nerve Sensitivity: Post-surgery, nerves in the area may be more sensitive as they heal. Standing may trigger a pain response due to this heightened sensitivity.

4. Inflammation: After surgery, inflammation is a natural part of the healing process. Standing may increase blood flow to the area, which can lead to increased pain if inflammation is present.

Remedies and Recommendations
1. Pain Management: It’s essential to manage pain effectively. Since your doctor has prescribed a suppository (益痔康栓劑), following the dosage instructions is crucial. If your doctor has advised increasing to twice daily, it’s generally safe to do so, but always confirm with your physician before making changes to medication.

2. Use of Topical Treatments: The 保痔寧軟膏 can be beneficial if you are experiencing discomfort. Even if you haven't felt discomfort before, using it now may help alleviate any pain or irritation you are experiencing. It’s designed to soothe the area and may provide relief.

3. Positioning: If standing is uncomfortable, consider shifting your weight or using a slight bend in your knees to relieve pressure on the anal area. You might also try to alternate between standing and sitting or walking to minimize discomfort.

4. Gentle Movement: Engaging in gentle movements or stretches may help alleviate tension in the pelvic area. However, avoid any strenuous activities that could strain the surgical site.

5. Follow-Up with Your Doctor: If the pain persists or worsens, it’s essential to follow up with your healthcare provider. They may want to assess the surgical site to ensure there are no complications, such as infection or excessive scarring.

6. Hydration and Diet: Maintaining a high-fiber diet and staying hydrated can help prevent constipation, which can exacerbate anal pain. Soft stools reduce strain during bowel movements, which is crucial during the healing process.

Conclusion
Experiencing pain when standing after rectal surgery is not uncommon, and it often relates to the healing process. By managing pain with prescribed medications, using topical treatments, and adjusting your activities, you can help alleviate discomfort. Always keep an open line of communication with your healthcare provider to ensure that your recovery is on track and to address any concerns you may have.

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