Post-Surgery Complications: Managing Fecal Incontinence After Hemorrhoid Surgery

Postoperative complications of ulcer surgery?

Several years ago, I underwent surgery for internal hemorrhoids after being treated by a physician.
However, in recent years, I have frequently experienced fecal incontinence, often discovering it unintentionally.
Sometimes, a small amount of stool is expelled along with gas, which is quite distressing.
I have had a follow-up examination by my original treating physician, who stated that the anal sphincter tone is still normal.
I would like to ask the director if there are any remedial options or surgical interventions available.
Thank you, director!

yukiko, 50~59 year old female. Ask Date: 2017/04/16

Dr. Ke Fangxu reply Surgery

Women of slightly older age often experience this issue due to the relaxation of the pelvic floor muscles caused by childbirth.
If there is mild anal incontinence, it can be improved with medication.
To determine whether it is truly a sphincter problem, a physical examination or machine assessment may be necessary.
If it is indeed due to sphincter damage, there are surgical options available for sphincter repair; however, it is essential to confirm that there is actual sphincter damage.
I recommend starting with medication treatment, and if the results are unsatisfactory, then consider further evaluation.

Reply Date: 2017/04/16

More Info

Post-surgery complications, particularly fecal incontinence following hemorrhoid surgery, can be a distressing issue for many patients. Fecal incontinence, or the involuntary loss of bowel control, can occur for various reasons, especially after surgical procedures involving the anal and rectal areas. In your case, it seems that the issue has developed some years after the surgery for internal hemorrhoids, which is not uncommon.

Firstly, it is essential to understand that surgical interventions in the anal region can sometimes lead to changes in the function of the anal sphincter muscles. These muscles are crucial for maintaining continence. If the surgery involved any manipulation or alteration of these muscles, it could potentially lead to issues such as fecal incontinence. Additionally, factors such as nerve damage, scarring, or changes in the anatomy of the rectal area can also contribute to this condition.

In your situation, where you have experienced involuntary leakage of stool or gas, it is vital to consider a few management strategies. Since your previous examination by the treating physician indicated that the anal sphincter tone was normal, it may be beneficial to explore other potential causes for your symptoms. Here are some options that you might consider:
1. Dietary Modifications: Sometimes, dietary changes can help manage symptoms of fecal incontinence. Increasing fiber intake can help solidify stool, making it easier to control. Additionally, avoiding foods that may irritate the bowel or cause diarrhea can also be beneficial.

2. Pelvic Floor Exercises: Engaging in pelvic floor exercises, commonly known as Kegel exercises, can strengthen the muscles of the pelvic floor and improve anal sphincter control. These exercises involve repeatedly contracting and relaxing the muscles used to stop urination.

3. Biofeedback Therapy: This is a technique that can help you gain more control over your bowel movements. A trained therapist can guide you through exercises that help you learn how to strengthen your pelvic floor muscles and improve your awareness of bowel sensations.

4. Medications: In some cases, medications may be prescribed to help manage symptoms. Antidiarrheal medications can help if loose stools are contributing to the problem.
5. Surgical Options: If conservative measures do not provide relief, surgical options may be available. Procedures such as sphincteroplasty (repair of the anal sphincter) or the implantation of a sacral nerve stimulator can be considered. These options are typically reserved for cases where other treatments have failed.

6. Consultation with a Specialist: It may be beneficial to seek a second opinion from a colorectal surgeon or a gastroenterologist who specializes in pelvic floor disorders. They can provide a comprehensive evaluation and recommend tailored treatment options based on your specific condition.

In conclusion, while fecal incontinence can be a challenging complication following hemorrhoid surgery, there are various management strategies available. It is crucial to have open discussions with healthcare providers about your symptoms and explore all possible avenues for treatment. Remember that you are not alone in this, and many patients experience similar challenges after such surgeries. Seeking help and being proactive about your health can lead to improved quality of life.

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