Post-Surgery Concerns: Yellow Mucus and Blood After Hemorrhoidectomy

After hemorrhoidectomy, there is still yellowish mucous discharge and a small amount of blood one month postoperatively?

Hello Dr.
Ke, I underwent a combined internal and external hemorrhoidectomy at the beginning of December.
On the seventh postoperative day, I experienced significant bleeding and went to the emergency room (without surgical sutures).
It has now been one month since the surgery, and I have no special discomfort; my bowel movements are normal (I am taking stool softeners).
However, I occasionally notice a small amount of yellow-green mucous discharge from the anus, which is more pronounced when I pass gas and sometimes contains a little blood-tinged fluid.
I have bowel movements twice a day, and there are slight blood stains on the last stool.
There is also a bit of blood-tinged fluid when I wipe.
Currently, I am applying a topical treatment for hemorrhoids, and I sometimes notice slight blood-tinged fluid when inserting the applicator for the medication.
I would like to ask you if this situation is a normal postoperative condition.
Should I increase the frequency of sitz baths or return for an evaluation? Thank you very much!

Niming, 20~29 year old female. Ask Date: 2017/01/04

Dr. Ke Fangxu reply Surgery

Generally, the wounds from hemorrhoid surgery heal completely within a month.
However, patients who have undergone surgery using a tissue coagulation device have reported slower wound healing.
You may be experiencing a similar situation.
If there is no redness, swelling, heat, or pain at the wound site, you can simply enhance your sitz baths.
As for the recovery time compared to traditional surgery, I have not performed surgery on patients using that device, so it would be best to consult the surgeon for more accurate information.

Reply Date: 2017/01/04

More Info

After undergoing a hemorrhoidectomy, it's not uncommon for patients to experience some unusual symptoms during the recovery phase. In your case, the presence of yellow-green mucus and occasional blood after the surgery raises some important considerations regarding your healing process.

Firstly, it's essential to understand that after a hemorrhoidectomy, the surgical site can be quite sensitive and may take time to heal. The yellow-green mucus you are experiencing could be a sign of normal post-operative drainage, especially if there is no accompanying fever or significant pain. However, the presence of blood, even in small amounts, should be monitored closely.

The fact that you had a significant bleeding episode shortly after your surgery is noteworthy. It suggests that your surgical site may still be vulnerable. The bleeding you describe, particularly when you wipe or during bowel movements, could be due to several factors:
1. Healing Process: The surgical site is likely still healing, and minor bleeding can occur as the tissues regenerate. This is especially true if you are experiencing any straining during bowel movements, even with the use of stool softeners.

2. Infection: The yellow-green mucus could indicate a possible infection, particularly if it is accompanied by an increase in pain, fever, or a foul odor. Infections can lead to increased drainage and bleeding.

3. Residual Hemorrhoids: If any hemorrhoidal tissue was left behind during the surgery, it could also contribute to bleeding and discharge.

4. Anal Fissures: Sometimes, the trauma of surgery can lead to the development of anal fissures, which can cause bleeding and discomfort during bowel movements.

Given your symptoms, here are some recommendations:
- Increase Sitz Baths: Continuing or increasing the frequency of sitz baths can help soothe the area, promote healing, and reduce discomfort. Warm water can also help with any muscle relaxation in the anal area, which may alleviate some of the pressure and discomfort.

- Monitor Symptoms: Keep a close eye on the amount of blood and any changes in the color or consistency of the mucus. If you notice an increase in bleeding, or if the mucus changes to a more concerning color (like dark brown or black), or if you develop a fever, it’s crucial to seek medical attention promptly.

- Follow-Up Appointment: It would be wise to schedule a follow-up appointment with your surgeon or a gastroenterologist. They can perform a thorough examination to ensure that your healing is progressing appropriately and rule out any complications such as infection or residual hemorrhoidal tissue.

- Diet and Hydration: Continue to maintain a high-fiber diet and stay well-hydrated to ensure soft stools and minimize straining during bowel movements. This will help reduce the risk of further irritation to the surgical site.

In conclusion, while some discharge and minor bleeding can be part of the normal healing process after a hemorrhoidectomy, it is essential to remain vigilant. If your symptoms persist or worsen, do not hesitate to reach out to your healthcare provider for further evaluation. Your health and comfort are paramount, and addressing any concerns early can help prevent complications down the line.

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