Post-Surgery Complications After Hemorrhoid Surgery

Post-hemorrhoid surgery

Dr.
Ke: Hello, I underwent traditional surgery for stage 4 internal hemorrhoids on September 11.
I would like to ask how long it typically takes to know if I have postoperative complications such as anal stenosis or fecal incontinence.
Currently, I have bowel movements 2-3 times a day, but my stools break apart in the water and do not form solid pieces.
I stopped taking stool softeners after the second week.
Now, I notice a small amount of yellowish, foul-smelling fluid leaking out; is this normal? Additionally, I feel the urge to have a bowel movement when I urinate and I am hesitant to push, so I urinate slowly.
Is this normal? Thank you, Dr.
Ke, for clarifying my concerns.

Xiao Xiang, 30~39 year old female. Ask Date: 2017/10/05

Dr. Ke Fangxu reply Surgery

It is normal to experience anal sensitivity after surgery.
Some patients may encounter bowel irregularities if they only consume soft foods postoperatively.
It is recommended to return to a normal diet while avoiding constipation, as most bowel issues will resolve themselves.
The discharge from the surgical site typically takes about a month to completely disappear.
During this period, it is advisable to take warm sitz baths to promote wound healing.
If normal function has not returned after one month post-surgery, it is important to consult the surgeon to check for any abnormalities.

Reply Date: 2017/10/05

More Info

After undergoing hemorrhoid surgery, particularly for advanced stages such as stage IV internal hemorrhoids, patients may experience a variety of post-operative complications. Understanding these potential complications and their timelines can help in managing expectations and seeking timely medical advice.

Common Post-Surgery Complications
1. Pain and Discomfort: It is common to experience pain following hemorrhoid surgery. This pain can vary in intensity and may last for several days to weeks. Pain management is crucial, and your healthcare provider may prescribe pain relief medications.

2. Bleeding: Some bleeding is expected after surgery, especially during the first few days. However, if you notice significant bleeding or blood in your stool, it is essential to contact your doctor.

3. Infection: The surgical site can become infected, leading to increased pain, swelling, and discharge. Signs of infection include fever, increased redness, and pus-like drainage.

4. Anal Stenosis: This is a narrowing of the anal canal that can occur after surgery. Symptoms may include difficulty passing stools, pain during bowel movements, or a feeling of incomplete evacuation. This complication may not become apparent until weeks or months after surgery.

5. Fecal Incontinence: Although rare, some patients may experience difficulty controlling bowel movements after surgery. This can be due to nerve damage or changes in the anal sphincter.

6. Changes in Bowel Habits: It is not uncommon to experience changes in bowel habits post-surgery. This can include diarrhea or softer stools, as your body adjusts to the surgical changes.

Timeline for Complications
- Immediate Post-Operative Period (0-2 weeks): During this time, you may experience pain, some bleeding, and potential signs of infection. It is crucial to monitor your symptoms closely.

- 2-6 Weeks Post-Surgery: Complications such as anal stenosis or fecal incontinence may start to become noticeable. If you experience persistent symptoms, such as difficulty urinating or a sensation of needing to defecate while urinating, it is advisable to consult your healthcare provider.

- 6 Weeks and Beyond: By this time, most acute symptoms should have resolved. If you continue to have issues with bowel movements or notice any unusual symptoms, further evaluation may be necessary.

Current Symptoms and Concerns
Regarding your current symptoms of yellowish discharge and the sensation of needing to defecate while urinating, these can be concerning. The yellow discharge may indicate a possible infection or a normal post-operative discharge, but it is essential to have it evaluated by your doctor. The sensation of needing to defecate while urinating could be related to swelling or irritation in the anal area, but it is also worth discussing with your healthcare provider to rule out any complications.

Recommendations
1. Follow-Up Appointments: Ensure you attend all scheduled follow-up appointments with your surgeon or healthcare provider. They can assess your healing process and address any complications.

2. Monitor Symptoms: Keep a close eye on your symptoms. If you experience increased pain, significant bleeding, or signs of infection, seek medical attention promptly.

3. Diet and Hydration: Maintain a high-fiber diet and stay hydrated to promote healthy bowel movements. This can help prevent constipation and reduce strain during bowel movements.

4. Avoid Straining: Try to avoid straining during bowel movements, as this can exacerbate symptoms and lead to complications.

5. Pain Management: Continue to manage pain as directed by your healthcare provider. If over-the-counter medications are insufficient, discuss alternative pain management options.

In conclusion, while some post-operative symptoms are normal, it is crucial to remain vigilant and proactive in your recovery. If you have any concerns or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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