Post-Surgery Bowel Issues: Frequent Urges and Discomfort Explained

After surgery, there is frequent urgency to urinate, making it difficult to work?

Hello Doctor: I was diagnosed with grade IV hemorrhoids and underwent surgery on August 9 (surgical excision for internal and external hemorrhoids with prolapse).
Currently, I have the following issues: (1) I experience frequent urges to defecate (every 2-5 minutes) but cannot pass stool, and I have uncontrollable leakage of a foul-smelling liquid (similar to diarrhea).
(2) I take warm sitz baths 4-5 times a day, during which more liquid stool leaks out.
(3) I drink about 2000 cc of water daily (small amounts frequently).
(4) My urination is also affected; I can only urinate while taking sitz baths.
Whenever I feel the urge to defecate, I become extremely uncomfortable and break into a cold sweat; it is painful whether I am sitting, lying down, or standing.
I have to endure it and wear disposable underwear to prevent leakage, and I cannot sleep, which has prevented me from going to work.
During my follow-up appointment on August 18, I informed the doctor, who prescribed a stool softener and mentioned that this is normal.
What should I do, Doctor? I am really uncomfortable.
Thank you for taking the time to address my concerns.
Thank you!

C Nan, 40~49 year old female. Ask Date: 2017/08/31

Dr. Ke Fangxu reply Surgery

After hemorrhoidectomy, pain should decrease after one week, and normal bowel movements should resume within two weeks.
Your situation is somewhat unusual, so it is advisable to consult the surgeon to understand the reasons.
If you are experiencing excessive bowel movements, you may consider reducing the use of stool softeners and replacing them with fiber supplements.

Reply Date: 2017/08/31

More Info

Post-surgery bowel issues, particularly after procedures like hemorrhoidectomy, can be quite distressing and uncomfortable. Your symptoms of frequent urges to defecate, inability to control bowel movements, and the presence of foul-smelling liquid discharge are concerning and warrant further evaluation. Here’s a detailed explanation of your situation and some recommendations based on medical knowledge.

Understanding Your Symptoms
1. Frequent Urges to Defecate: After surgery for hemorrhoids and prolapse, it is not uncommon to experience changes in bowel habits. The surgical site may be inflamed or sensitive, leading to increased urgency. This can be exacerbated by the body's natural response to surgery, which can include increased bowel motility.

2. Liquid Discharge: The presence of liquid stool or discharge can indicate several issues. It may be a result of irritation in the rectal area post-surgery, leading to mucus production or a change in stool consistency. If there is an infection or inflammation, this could also contribute to the symptoms you are experiencing.

3. Impact on Urination: The fact that you are experiencing difficulties with urination, only being able to urinate during sitz baths, suggests that there may be some degree of pelvic floor dysfunction or irritation affecting the bladder and urethra. This can happen after surgeries in the pelvic region due to swelling or nerve irritation.

Recommendations
1. Follow-Up with Your Surgeon: It is crucial to maintain open communication with your healthcare provider. If your symptoms are worsening or not improving, you should return for a follow-up appointment. Your surgeon may need to assess for any complications such as infection, abscess formation, or issues related to the surgical site.

2. Medication Review: You mentioned that your doctor prescribed stool softeners. Ensure that you are taking them as directed. Additionally, if you are still experiencing significant discomfort, discuss the possibility of adjusting your medications or adding new ones to help manage your symptoms.

3. Dietary Adjustments: Focus on a high-fiber diet to help regulate your bowel movements. Foods rich in fiber can help form more solid stools and reduce the frequency of liquid discharge. Consider incorporating fruits, vegetables, whole grains, and legumes into your meals. Staying hydrated is also essential, so continue drinking plenty of fluids.

4. Sitz Baths: Continue with sitz baths as they can help soothe the area and promote healing. Warm water can alleviate discomfort and help with relaxation, which may reduce the urgency you feel.

5. Pelvic Floor Therapy: If your symptoms persist, consider asking your doctor about pelvic floor physical therapy. A specialized therapist can help you strengthen the pelvic floor muscles, which may improve both bowel and bladder function.

6. Monitoring Symptoms: Keep a detailed log of your symptoms, including the frequency of urges, the consistency of your stool, and any other associated symptoms. This information can be invaluable for your healthcare provider in diagnosing and treating your condition.

Conclusion
Post-surgical bowel issues can be complex and multifaceted. It is essential to work closely with your healthcare provider to address your symptoms and ensure proper healing. While some discomfort is expected after surgery, significant changes in bowel habits or urinary function should not be overlooked. By taking proactive steps and maintaining communication with your medical team, you can work towards regaining your comfort and normal function. Remember, your health and well-being are paramount, and seeking help is a vital part of the recovery process.

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