Post-Surgery Bowel Movements: Discomfort After Hemorrhoid Surgery

After hemorrhoid surgery, bowel movements may require straining?

Hello Doctor, I apologize for bothering you.
I underwent traditional surgery for grade IV internal and external hemorrhoids on October 18th, and it has been nearly a month since then.
Currently, the wound is not very painful, and I have bowel movements at least four times a week.
However, each time I have to exert myself several times to pass stool, which feels uncomfortable as if my anus is being stretched.
The stool varies in size, and I experience a prickling sensation (which goes away after I finish).
There is blood in the stool, and sometimes there is a small amount of bleeding from the anus.
Is this considered normal? Will it gradually improve and return to my previous bowel regularity? I started jogging three weeks after the surgery, about three times a week; will this affect my recovery? Could you please clarify my concerns? Thank you very much.
(I am not taking any medication.)

Li Li, 30~39 year old female. Ask Date: 2016/11/18

Dr. Ke Fangxu reply Surgery

After hemorrhoidectomy, the wound will fully heal in about a month.
However, it is essential to avoid constipation post-surgery, as it can negatively affect the healing process.
Given your frequency of bowel movements four times a week, this indicates mild constipation.
It is recommended to prevent constipation during this period and to shorten the time spent on the toilet.
Warm sitz baths may also help alleviate symptoms.
At your age, increasing your intake of dietary fiber and fluids should be sufficient.
If necessary, you may also consider taking a stool softener.
If you continue to experience bleeding and pain, it is best to consult a physician for evaluation.

Reply Date: 2016/11/18

More Info

After undergoing hemorrhoid surgery, it is not uncommon to experience discomfort during bowel movements, especially in the weeks following the procedure. Your symptoms, including the need to exert effort to pass stools, the sensation of discomfort or pain during bowel movements, and the presence of blood in the stool, can be concerning but may also be part of the healing process.
Firstly, it is important to understand that hemorrhoid surgery, particularly for advanced cases like grade IV hemorrhoids, involves significant manipulation of the tissues in the anal region. This can lead to temporary changes in bowel habits and sensations. The discomfort you describe, such as the feeling of your anus being stretched or the sensation of needing to push hard, is often due to swelling, inflammation, or sensitivity in the area as it heals.
The presence of blood in your stool, especially if it is bright red and appears only during bowel movements, can be a sign of irritation or minor trauma to the surgical site or surrounding tissues. This is not uncommon after surgery, but it is crucial to monitor the amount and frequency of bleeding. If it becomes more than just a few drops or if you experience significant pain, it would be wise to consult your surgeon or healthcare provider.

Regarding your question about whether these symptoms will improve over time, the answer is generally yes. Most patients find that their bowel movements become more comfortable as the surgical site heals and inflammation decreases. However, this process can take several weeks to months, depending on individual healing rates and adherence to post-operative care recommendations.

In terms of your exercise routine, light activities such as jogging can be beneficial for overall recovery, but it is essential to listen to your body. If you experience increased discomfort or bleeding after running, it may be wise to reduce the intensity or frequency of your workouts until you feel more comfortable. Engaging in gentle exercises, such as walking or stretching, can help promote circulation and healing without putting too much strain on your body.

To facilitate smoother bowel movements and reduce discomfort, consider the following recommendations:
1. Dietary Adjustments: Ensure you are consuming a high-fiber diet, which includes fruits, vegetables, whole grains, and legumes. Fiber helps to soften stools and makes them easier to pass. You might also consider fiber supplements if you struggle to get enough from your diet.

2. Hydration: Drink plenty of water throughout the day. Staying well-hydrated can help prevent constipation and promote regular bowel movements.

3. Stool Softeners: If you continue to experience hard stools, over-the-counter stool softeners can be beneficial. These can help ease the passage of stools without straining.

4. Warm Baths: Taking warm sitz baths can help soothe the anal area and promote relaxation, which may ease discomfort during bowel movements.

5. Avoid Straining: Try to avoid straining during bowel movements. If you feel the urge to go, take your time and do not rush the process.

6. Follow-Up Care: Regular follow-up with your surgeon is crucial. If your symptoms persist or worsen, do not hesitate to reach out for further evaluation and management.

In summary, while discomfort after hemorrhoid surgery can be expected, it is essential to monitor your symptoms closely. With appropriate care and attention to your diet and activity levels, you should see improvement in your bowel habits and overall comfort in the weeks to come. If you have any concerns or if your symptoms do not improve, please consult your healthcare provider for personalized advice and treatment options.

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