Post-Surgery Bleeding: Hemorrhoid Recovery Challenges

One month after hemorrhoid surgery, there is bleeding during bowel movements?

Dear Director Ke,
I underwent traditional excision surgery for internal and external hemorrhoids at the hospital at the end of October, and it has been a little over a month since then.
Recently, due to work, I have been sitting for long periods and have had an irregular diet, along with insufficient water intake.
Although I have been taking a stool softener before bed, I am still experiencing constipation.
I find that I need to exert myself to have a bowel movement, and afterward, there is bright red blood dripping.
I would like to ask if these symptoms indicate a recurrence of hemorrhoids.
Is there a high likelihood of recurrence shortly after hemorrhoid surgery? Additionally, could you please advise how long one should generally sit or stand before getting up to move around?
Thank you.

Niming, 20~29 year old female. Ask Date: 2016/12/07

Dr. Ke Fangxu reply Surgery

The hemorrhoidectomy does not involve the complete removal of all hemorrhoidal tissue; it is necessary to retain some hemorrhoidal tissue to prevent anal incontinence.
Therefore, it is important to maintain good bowel habits after surgery.
Otherwise, the remaining hemorrhoidal tissue may still bleed, which is not considered a recurrence.
As long as one increases dietary fiber intake and maintains healthy lifestyle and bowel habits, bleeding should not occur again.
It is generally recommended to get up and move around every hour, similar to attending a class, to promote good blood circulation.

Reply Date: 2016/12/07

More Info

Post-surgery complications, particularly in the context of hemorrhoid surgery, can be quite challenging for patients. It’s important to understand the nature of your symptoms and the potential for recovery. Based on your description, it seems you are experiencing symptoms that could indicate a recurrence of hemorrhoids or complications related to your recent surgery.

Firstly, the presence of bright red blood after a bowel movement is a common symptom associated with hemorrhoids. This bleeding can occur due to several reasons, including straining during bowel movements, which is often exacerbated by constipation. Since you mentioned that you have been experiencing constipation and have to exert effort to pass stool, this could indeed lead to irritation or re-injury of the hemorrhoidal tissue, resulting in bleeding.

In terms of the likelihood of recurrence after hemorrhoid surgery, it is generally accepted that while surgical intervention can significantly reduce the symptoms and complications associated with hemorrhoids, there is still a possibility of recurrence. Factors that can contribute to this include dietary habits, hydration levels, and lifestyle choices. Inadequate fluid intake and a diet low in fiber can lead to constipation, which increases the risk of straining and subsequently aggravating or re-developing hemorrhoids.

To address your concerns about activity levels post-surgery, it is advisable to avoid prolonged periods of sitting or standing without breaks. Generally, it is recommended to take a break every 30 to 60 minutes to stand up, stretch, and walk around. This not only helps improve circulation but also reduces the pressure on the rectal area, which can alleviate some discomfort and help prevent complications.

In addition to increasing your activity levels, consider making dietary adjustments to improve your bowel health. Incorporating more fiber-rich foods such as fruits, vegetables, and whole grains can help soften your stool and make bowel movements easier. Staying well-hydrated is equally important; aim to drink plenty of water throughout the day. If you continue to experience constipation despite these changes, you may want to consult your healthcare provider about adjusting your stool softener or exploring other options.

If the bleeding persists or worsens, or if you experience significant pain, it is crucial to seek medical attention. Your healthcare provider may want to evaluate your condition further to rule out any complications from the surgery or other underlying issues. Regular follow-ups with your healthcare provider can help monitor your recovery and address any concerns that arise.

In summary, while it is possible that your symptoms indicate a recurrence of hemorrhoids, they could also be related to the effects of constipation and straining. Implementing lifestyle changes, such as increasing physical activity and improving your diet, can significantly aid in your recovery. Always keep an open line of communication with your healthcare provider to ensure that you are on the right track towards healing.

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