Post-Surgery Bowel Issues After Hemorrhoidectomy: Solutions and Tips

Postoperative bowel issues after hemorrhoid surgery?

Hello! I underwent a traditional excision surgery for grade III mixed hemorrhoids five days ago.
On the first day post-surgery, I experienced diarrhea-like bowel movements due to taking a stool softener.
After stopping the stool softener, I had two more days of bowel movements, but since the fourth day, I haven't been able to have a bowel movement.
I have been passing gas, but I haven't had any success in the bathroom for five minutes.
At the same time, I am experiencing some difficulty urinating; I have to concentrate to activate my bladder muscles.
The surgical site is still very painful, and I am taking a prescription painkiller every four hours.
My diet over the past few days has mainly consisted of vegetable porridge, fish, two liters of water, and fruits like bananas.
Could my inability to have a bowel movement be due to not eating enough? However, my abdomen feels bloated.
What methods can I use to address the issue of not being able to have normal bowel movements? Thank you!

Xiao W, 30~39 year old female. Ask Date: 2017/08/18

Dr. Ke Fangxu reply Surgery

Postoperative pain and difficulty with bowel movements are common issues after hemorrhoid surgery, so a stool softener is typically prescribed.
If diarrhea occurs as directed, the dosage can be adjusted accordingly.
Generally, these symptoms improve within a week after surgery.
If there is no improvement, a follow-up with the physician for further evaluation and medication may be necessary.

Reply Date: 2017/08/18

More Info

After undergoing a hemorrhoidectomy, it is not uncommon to experience bowel issues, including constipation, difficulty in urination, and pain at the surgical site. These symptoms can be attributed to several factors, including the effects of anesthesia, pain medications, dietary changes, and the body's natural healing process.

Understanding Post-Surgery Bowel Issues
1. Constipation: After surgery, especially one involving the rectal area, it is common for patients to experience constipation. This can be exacerbated by the use of pain medications, particularly opioids, which can slow down bowel motility. Additionally, if you have recently stopped taking stool softeners, this could lead to harder stools, making it more difficult to pass.

2. Dietary Factors: Your current diet, while including healthy options like vegetables and fruits, may not be providing enough fiber or bulk to stimulate bowel movements. It's essential to ensure that you are consuming adequate fiber, which can help promote regularity. Foods high in fiber include whole grains, legumes, fruits, and vegetables.

3. Hydration: Staying well-hydrated is crucial for maintaining bowel health. While you mentioned drinking two liters of water, ensure that this is consistent throughout the day. Dehydration can lead to harder stools and constipation.

4. Pain and Discomfort: The pain from the surgical site can also contribute to difficulty in having a bowel movement. If you are hesitant to push due to pain, this can create a cycle of constipation. It’s important to manage your pain effectively, as this can help you feel more comfortable and encourage bowel movements.

5. Urinary Issues: Difficulty urinating can occur post-surgery, particularly if you are taking pain medications. The pelvic floor muscles may also be tense due to pain or anxiety about bowel movements, further complicating urination.

Solutions and Tips
1. Gradual Reintroduction of Stool Softeners: If you have stopped taking stool softeners, consider reintroducing them, but consult with your healthcare provider first. They can recommend the appropriate type and dosage.

2. Increase Fiber Intake: Aim to include more high-fiber foods in your diet. Consider adding whole grain cereals, beans, lentils, and more fruits and vegetables. A fiber supplement may also be beneficial, but again, consult your doctor before starting any new supplements.

3. Hydration: Continue to drink plenty of fluids. If plain water is not appealing, consider herbal teas or broths to increase fluid intake.

4. Gentle Physical Activity: If you are able, gentle walking can help stimulate bowel movements. However, avoid any strenuous activities that could strain your surgical site.

5. Pain Management: Discuss your pain management plan with your healthcare provider. If your current pain medication is causing constipation, they may be able to adjust your prescription or suggest alternatives.

6. Scheduled Bathroom Time: Try to establish a routine for using the bathroom. Set aside time each day to sit on the toilet, even if you don’t feel the urge. This can help train your body to recognize when it’s time to go.

7. Relaxation Techniques: Stress and anxiety can exacerbate bowel issues. Consider relaxation techniques such as deep breathing, meditation, or gentle yoga to help ease tension.

8. Follow-Up with Your Doctor: If you continue to experience significant issues with bowel movements or urination, it’s crucial to follow up with your healthcare provider. They may need to evaluate your situation further and provide additional interventions.

In conclusion, while post-surgery bowel issues can be frustrating, they are often manageable with the right strategies. Focus on a balanced diet, adequate hydration, effective pain management, and regular follow-ups with your healthcare provider to ensure a smooth recovery.

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