Post-Surgery Concerns: Hard Stools and Bleeding After Hemorrhoid Surgery

After surgery in the morning, I wanted to have a bowel movement in the afternoon, but the stool was very hard and there was bleeding from the anus?

The day before the surgery, I really wanted to have a bowel movement but had no urge.
On November 7th, I underwent hemorrhoid surgery around 10 AM.
Because I hadn't had a bowel movement the day before, I suddenly felt an urge to go at around 2 PM.
I couldn't hold it anymore and went to the bathroom.
I soaked in warm water first, but my stool was very hard.
After a while, only small pieces came out.
I soaked again in warm water and tried again.
I was hesitant to strain because I had just had surgery, but after a long time, I realized it wasn't good for my anus, so I pushed with my abdomen and finally managed to pass it.
I looked in the toilet and saw blood; I wasn't sure if it was from a tear in the surgical site since I couldn't feel anything.
After soaking, I used a cotton swab to check and found only a little blood, like a minor abrasion, not enough to fully stain the swab, but I was still very worried.
After the bowel movement, I felt a dull pain.
Initially, after the surgery, I wasn't in much pain, just discomfort from the gauze making me want to go.
I had the surgery on November 7th and my follow-up appointment is on November 12th.
I'm unsure if I need to seek help from a doctor earlier.
I know that typically, patients have a bowel movement the day after surgery, and my situation seems rare.
I'm very concerned that I might have developed an anal fissure again.

Da Shan, 20~29 year old female. Ask Date: 2016/11/07

Dr. Ke Fangxu reply Surgery

After hemorrhoid surgery, the biggest concern is constipation.
Straining to have a bowel movement or passing hard stools can cause bleeding from the surgical site, especially if it hasn't fully healed.
If there is no ongoing bleeding from the anus, it is not a major issue; just be careful to avoid further constipation.
However, if the bleeding persists or is significant, you should return to the clinic promptly.

Reply Date: 2016/11/07

More Info

After undergoing hemorrhoid surgery, it is not uncommon to experience concerns related to bowel movements, especially regarding hard stools and potential bleeding. Your situation raises several important points that need to be addressed.

Firstly, it is essential to understand that after any surgical procedure, particularly one involving the rectal area, the body may react in various ways. The fact that you had not had a bowel movement the day before your surgery can contribute to the hardness of your stools. When stools are hard, they can cause discomfort and strain during bowel movements, which is particularly concerning after surgery, as straining can lead to complications such as bleeding or even reopening of the surgical site.

The presence of blood in the toilet after a bowel movement can understandably cause alarm. However, it is important to differentiate between minor bleeding that may occur due to irritation or minor trauma to the surgical site and more significant bleeding that would require immediate medical attention. The fact that you only noticed a small amount of blood on a cotton swab suggests that it may not be severe, but it is still crucial to monitor the situation closely.

Here are some recommendations to help manage your post-operative recovery and alleviate your concerns:
1. Hydration and Diet: Ensure you are drinking plenty of fluids and consuming a diet high in fiber. This can help soften your stools and make bowel movements easier. Foods such as fruits, vegetables, whole grains, and legumes can be beneficial.

2. Stool Softeners: Over-the-counter stool softeners can be helpful in preventing hard stools. These medications work by drawing water into the stool, making it easier to pass. Consult your doctor or pharmacist for recommendations on which stool softeners are appropriate for you.

3. Warm Baths: Continuing to take warm baths can help relax the anal muscles and soothe discomfort. This practice can also promote blood flow to the area, which may aid in healing.

4. Avoid Straining: It is crucial to avoid straining during bowel movements. If you feel the urge to go, try to respond promptly, but if you are having difficulty, do not force it. Instead, give yourself time and try again later.

5. Monitor Symptoms: Keep an eye on your symptoms. If you experience increased pain, significant bleeding, or any signs of infection (such as fever or unusual discharge), it is essential to contact your healthcare provider immediately.

6. Follow-Up Care: Since your follow-up appointment is not until November 12, if you continue to have concerns or if your symptoms worsen, do not hesitate to reach out to your surgeon or healthcare provider for advice. It is better to err on the side of caution, especially after surgery.

In summary, while your experience of hard stools and some bleeding after hemorrhoid surgery is concerning, it is not uncommon. By taking proactive steps to manage your bowel health and monitoring your symptoms, you can help facilitate a smoother recovery. If in doubt, always consult your healthcare provider for personalized advice and reassurance.

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