Post-Surgery Care for Hemorrhoids: Bathing During Menstruation and Pain Relief Options

After hemorrhoid surgery, if it coincides with your menstrual period, is it advisable to continue taking sitz baths or should you switch to using a heating pad for the wound?

Hello Dr.
Ke, I have been suffering from hemorrhoids for nearly seven years.
In addition to occasionally experiencing significant bleeding after bowel movements, I also have external hemorrhoids that cause severe pain after defecation.
I was diagnosed with stage IV mixed hemorrhoids, and since it has severely affected my daily life, I was scheduled for traditional surgery the day after my first consultation.
After the surgery, I have been having bowel movements two to three times a day and have diligently followed the doctor's advice to take sitz baths and apply medication.
I had a follow-up appointment on the sixth day post-surgery, but the doctor only prescribed me tetracycline hydrochloride and did not provide any other medications.
Now, on the ninth day post-surgery, I still experience considerable pain after each bowel movement.
Although I should be using sitz baths for relief, it unfortunately coincides with my menstrual period.
May I continue to take sitz baths, or should I consider using heat or cold packs for relief? Additionally, the doctor has not prescribed any painkillers, but sometimes the pain is unbearable.
Is it acceptable for me to take over-the-counter pain relievers like Tylenol? I appreciate your response and apologize for the inconvenience!

Li, 30~39 year old female. Ask Date: 2017/06/15

Dr. Ke Fangxu reply Surgery

Generally, pain after hemorrhoid surgery significantly alleviates within a week, and it usually resolves completely around two to three weeks post-surgery.
If it coincides with the menstrual period, the pain may indeed intensify.
Taking over-the-counter pain relievers should be fine, but it is important not to exceed the recommended dosage.
If the pain persists or if there is redness and swelling, it is essential to consult a physician for further evaluation.

Reply Date: 2017/06/15

More Info

Post-surgery care for hemorrhoids, especially after a traditional surgical procedure for advanced mixed hemorrhoids, is crucial for recovery and pain management. Given your situation, where you are experiencing significant pain after bowel movements, it is essential to follow a structured approach to care.

Bathing During Menstruation
You mentioned that your menstruation coincides with your recovery period. It is generally safe to continue taking sitz baths during your menstrual cycle. Sitz baths can help soothe the area and promote healing, even if you are menstruating. However, ensure that the water is warm, not hot, and that you maintain good hygiene to prevent any potential infections. After bathing, gently pat the area dry with a clean towel instead of rubbing, which can cause irritation.

Pain Relief Options
Regarding pain management, it is understandable that you are experiencing discomfort after bowel movements. While your doctor prescribed tetracycline hydrochloride, which is an antibiotic, it seems that you are in need of additional pain relief. Since your physician did not prescribe any analgesics, you may consider over-the-counter options such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain relief. However, it is crucial to follow the recommended dosage on the packaging and to consult with your healthcare provider before starting any new medication, especially if you have any underlying health conditions or are taking other medications.

Additional Recommendations
1. Dietary Adjustments: To ease bowel movements and reduce strain, consider increasing your fiber intake. Foods rich in fiber, such as fruits, vegetables, whole grains, and legumes, can help soften stools. Staying well-hydrated by drinking plenty of water is also essential.

2. Stool Softeners: If you continue to experience pain during bowel movements, you might want to discuss the possibility of using stool softeners with your doctor. These can help make bowel movements less painful.

3. Avoid Straining: It is crucial to avoid straining during bowel movements, as this can exacerbate pain and hinder healing. If you feel the urge to go, try to respond promptly rather than holding it in.

4. Follow-Up Care: Since you are experiencing ongoing pain, it is advisable to schedule a follow-up appointment with your surgeon or healthcare provider. They can assess your healing progress and determine if further intervention is necessary.

5. Pain Management Techniques: In addition to medications, consider other pain management techniques such as applying a cold pack to the area (wrapped in a cloth to avoid direct contact with the skin) to reduce swelling and numb the pain. Heat can also be soothing, but it is best to use it after the initial swelling has gone down.

6. Monitor for Complications: Keep an eye out for any signs of complications, such as increased bleeding, fever, or worsening pain. If you notice any of these symptoms, seek medical attention promptly.

In conclusion, while it is essential to manage pain effectively during your recovery from hemorrhoid surgery, it is equally important to maintain communication with your healthcare provider. They can provide tailored advice based on your specific situation and ensure that your recovery progresses smoothly.

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