Post-Surgery Bowel Issues After Hemorrhoid Surgery: What to Expect

Post-operative bowel issues after hemorrhoid surgery?

I had surgery on January 3rd, and it has been over two months since then.
My last follow-up appointment was on February 21st, and the doctor said everything looked fine, so I didn't need to come back.
He also mentioned that I could stop taking medication and applying ointment, and even that sitz baths were no longer necessary, as the wound had healed well.
Personally, I feel that the wound has indeed recovered quickly and is almost back to normal.
However, recently, for some unknown reason, whether I have a smooth bowel movement or experience slight constipation, I occasionally feel a stinging sensation around the scar on my anus after having a bowel movement.
It’s quite uncomfortable, and when I check with toilet paper, I notice a very small amount of blood.
I'm not sure if this is due to hard stools irritating the anus or if the wound hasn't fully healed yet.
Post-surgery, I generally don't experience pain anymore and can maintain a normal routine, but this issue is causing me some concern and worry.
I would greatly appreciate your guidance, Dr.
Ke.
Thank you very much!

Yo, 30~39 year old female. Ask Date: 2018/03/15

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like the typical symptoms of an anal fissure, which include pain during bowel movements accompanied by slight bleeding.
The cause may be due to hard stools.
The fundamental treatment is to improve bowel habits, along with warm sitz baths.
You can also purchase hemorrhoid suppositories at the pharmacy for relief.
However, the key to preventing recurrence is to increase dietary fiber intake and develop good bowel habits.

Reply Date: 2018/03/15

More Info

After undergoing hemorrhoid surgery, it is not uncommon to experience some bowel-related issues, especially in the weeks and months following the procedure. Your concerns about noticing small amounts of blood and discomfort around the surgical site after bowel movements are valid and warrant attention.
Firstly, it is important to understand that hemorrhoid surgery can lead to changes in bowel habits and sensations. The surgical site may still be sensitive, and as you mentioned, you might experience a sensation of tearing or discomfort, particularly if your stool is hard or if you are experiencing any degree of constipation. This can happen because the anal area is healing, and any strain during bowel movements can cause irritation or even minor fissures in the skin surrounding the anus.

The presence of small amounts of blood after a bowel movement can be attributed to a few factors:
1. Anal Fissures: These are small tears in the lining of the anus that can occur due to passing hard stools. They can cause sharp pain and bleeding during or after bowel movements. Given your description, it is possible that the discomfort and slight bleeding you are experiencing could be due to a fissure.

2. Residual Effects of Surgery: Even though your doctor has indicated that the surgical site is healing well, it is possible that the area is still sensitive and may react to the passage of stool, especially if it is not well-formed.
3. Hemorrhoid Recurrence: Although you have undergone surgery, it is still possible for hemorrhoids to recur, especially if there are underlying issues with bowel habits or straining during defecation.

4. Diet and Hydration: Your diet plays a crucial role in the consistency of your stool. A diet low in fiber or inadequate hydration can lead to harder stools, which can exacerbate the issues you are experiencing.
To address your concerns, here are some recommendations:
- Increase Fiber Intake: Incorporate more fiber-rich foods into your diet, such as fruits, vegetables, whole grains, and legumes. This can help soften your stool and make bowel movements easier.

- Stay Hydrated: Drinking plenty of water is essential for maintaining stool consistency. Aim for at least 8-10 glasses of water a day.

- Consider Stool Softeners: If you continue to experience hard stools, you might want to discuss with your healthcare provider the possibility of using stool softeners or mild laxatives to ease the passage of stool.

- Gentle Care: After bowel movements, be gentle when cleaning the area. Avoid excessive wiping, which can irritate the skin further. Instead, consider using moist wipes or a bidet if available.

- Monitor Symptoms: Keep an eye on the amount of blood and any changes in your symptoms. If the bleeding persists or worsens, or if you experience significant pain, it is crucial to follow up with your healthcare provider for further evaluation.

- Follow-Up Appointments: Even if your doctor has indicated that you do not need to return, if you have ongoing concerns, it is always appropriate to seek a follow-up appointment. Your health and comfort are paramount, and your doctor can provide reassurance or additional treatment options if necessary.

In summary, while some discomfort and minor bleeding can be expected after hemorrhoid surgery, it is essential to manage your bowel habits and monitor your symptoms closely. If you have any doubts or if your symptoms persist, do not hesitate to reach out to your healthcare provider for further guidance.

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