Post-Surgery Complications: Managing Pain and Infection After Hemorrhoid Surgery

Post-hemorrhoid surgery

Hello Doctor, I would like to ask about my condition.
I had surgery for internal and external hemorrhoids on April 27.
After the surgery, I experienced wound infection, swelling, and pus formation.
After a follow-up visit, I was prescribed antibiotics, and following the doctor's advice, the internal abscess and swelling have resolved.
The doctor mentioned that the internal wound has healed.
However, the external surgical site continues to have swelling and a hard lump.
When I go to the bathroom, the pressure causes pus, blood, and discharge-like fluid to be expelled from the area around the anus.
After expelling this fluid, the sharp pain at the wound significantly alleviates, but about half an hour to an hour after each bowel movement, the pain returns, and I find myself needing to apply pressure again.
This situation has been recurring for almost two months.
Could this possibly indicate the development of a fistula after surgery? The swollen area has not decreased in size after two months.
How should I manage this? Is it abnormal for the external wound to produce pus after a bowel movement?

Lin Xiansheng, 20~29 year old female. Ask Date: 2018/06/28

Dr. Ke Fangxu reply Surgery

After hemorrhoid surgery, there is a possibility of wound infection leading to the development of an anal fistula.
It is generally recommended to use antibiotics for a period of time.
If symptoms recur, surgical treatment may be necessary.

Reply Date: 2018/06/28

More Info

After undergoing hemorrhoid surgery, it is not uncommon for patients to experience complications such as pain, swelling, and infection. Your situation, where you have persistent swelling and discharge from the surgical site, raises several important considerations regarding post-operative care and potential complications.

First, it is essential to understand that some degree of pain and swelling is expected after hemorrhoid surgery. However, when these symptoms persist for an extended period, especially with the presence of pus and blood, it may indicate an underlying issue such as an infection or the formation of a fistula (an abnormal connection between the anal canal and the skin).

In your case, the fact that you have been experiencing ongoing pain and discharge for nearly two months suggests that the healing process may not be proceeding as expected. The presence of a hard lump and the need to manually express pus and blood from the surgical site are concerning signs. While some patients may experience temporary swelling and discomfort, persistent symptoms warrant further evaluation.

Here are some steps you can take to manage your situation:
1. Follow-Up with Your Surgeon: It is crucial to return to your surgeon or healthcare provider for a thorough examination. They may need to assess the surgical site for any signs of infection, abscess formation, or the development of a fistula. Imaging studies, such as an ultrasound or MRI, may be necessary to evaluate the extent of any complications.

2. Pain Management: If you are experiencing significant pain, discuss pain management options with your healthcare provider. They may recommend over-the-counter pain relievers or prescribe stronger medications if necessary.

3. Wound Care: Proper wound care is vital for healing. Keep the area clean and dry, and follow any specific instructions provided by your surgeon regarding cleaning and dressing changes. Warm sitz baths can help soothe the area and promote healing.

4. Dietary Considerations: To prevent constipation and straining during bowel movements, maintain a high-fiber diet and stay well-hydrated. This can help minimize pressure on the surgical site and reduce the risk of further complications.

5. Monitor Symptoms: Keep track of any changes in your symptoms, such as increased pain, fever, or changes in the nature of the discharge. If you notice any concerning signs, seek medical attention promptly.

6. Consideration of Fistula Formation: If a fistula is suspected, surgical intervention may be necessary to address the issue. Fistulas can lead to recurrent infections and discomfort, so timely management is essential.

In summary, while some discomfort and swelling are normal after hemorrhoid surgery, the persistence of these symptoms, especially with discharge, is not typical and should be evaluated by a healthcare professional. Early intervention can help prevent further complications and promote a more effective recovery. Don't hesitate to seek medical advice to address your concerns and ensure proper healing.

Similar Q&A

Post-Hemorrhoid Surgery: Common Concerns and Pain Management

Hello, doctor. It has been four days since my external hemorrhoidectomy, and I am still experiencing unbearable pain. The area around the wound is swollen around half of the anus. I have been lying in bed and relying on painkillers to manage my daily activities. However, I read t...

Dr. Ke Fangxu reply Surgery
Personally, I have not undergone outpatient hemorrhoidectomy because postoperative swelling and pain are inevitable. Mild bleeding and discharge are also considered normal. During this time, it is not recommended to apply ointments to avoid compromising wound cleanliness. Frequen...

Post-Surgery Complications: Understanding Wound Healing After Hemorrhoid Surgery

Hello, Doctor! Thank you for taking the time to respond to my message! The situation is as follows: My husband, who is 48 years old, has diabetes and hyperlipidemia. Recently, he suddenly developed a painful protrusion at the anal area, about the size of two finger joints. He con...

Dr. Ke Fangxu reply Surgery
It may be caused by a rupture of the wound from the ultrasound knife. At this time, the only options are to enhance sitz baths and apply topical medications. If there is pain or inflammation, oral medications can also be added for treatment while waiting for the wound to heal. At...

How Common Are Complications After Hemorrhoid Surgery?

It is often seen on websites that patients experience some complications after hemorrhoid surgery, such as persistent pain, anal tightness, or fecal incontinence after a period of time. Even when treated by a qualified colorectal surgeon, what is the likelihood of these issues oc...

Dr. Ke Fangxu reply Surgery
Hello: In response to your question, the pain after hemorrhoid surgery typically lasts about one to two weeks, with the most intense pain occurring during the first three days. Therefore, hospitalization is recommended during this period. After that, there may still be some disco...

Post-Surgery Pain: Managing Discomfort After Fistula and Hemorrhoid Surgery

Hello, Dr. Ke. I had surgery for a fistula and also had an external hemorrhoid removed. It is now the fourth day post-surgery, and I was discharged the day after the operation. Since returning home, I have been experiencing diarrhea for two days, with about four episodes each day...

Dr. Ke Fangxu reply Surgery
After fistula surgery, if diarrhea occurs, it may lead to wound pain and bleeding. It is recommended to increase the frequency of sitz baths. If the pain does not improve, you should consult your physician for an examination and medication.