Post-Surgery Anal Pain: Discomfort After Hemorrhoid Surgery

Postoperative pain from anal sphincter contraction (kegel exercises) after hemorrhoid surgery?

Hello Dr.
Ke: I apologize for bothering you with a question.
It has been about a month since my surgery, and I generally feel better.
However, I have one issue that has been troubling me.
When I relax my anus, there are no significant problems, but when I try to contract or lift my pelvic floor, I experience pain that is very uncomfortable.
Could this be due to the wound not healing properly, or is there another issue? I would appreciate your help in clarifying this.
Thank you!

Kun, 40~49 year old female. Ask Date: 2018/09/16

Dr. Ke Fangxu reply Surgery

After hemorrhoid surgery, the wound should be completely healed within a month.
If you experience significant discomfort when performing Kegel exercises, it may not be normal.
I'm not sure which surgical method you underwent; if it was a hemorrhoidectomy, it might not be resolvable.
However, if it was a traditional surgery, the symptoms should gradually improve.

Reply Date: 2018/09/16

More Info

Post-surgery anal pain, particularly after hemorrhoid surgery, can be a common concern for many patients. It’s important to understand that the recovery process can vary significantly from person to person, and several factors can contribute to the discomfort you are experiencing.

Firstly, it’s essential to recognize that hemorrhoid surgery, whether it’s a hemorrhoidectomy or another procedure, involves cutting and removing tissue, which can lead to pain and discomfort during the healing process. The pain you feel when contracting the anal sphincter (the muscle that controls the opening and closing of the anus) could be attributed to several factors:
1. Healing Process: After surgery, the tissues in the anal area need time to heal. If you are experiencing pain during contractions, it may indicate that the surgical site is still healing. The healing process can take several weeks, and it’s not uncommon for patients to experience discomfort during this time, especially when engaging the muscles around the surgical site.

2. Muscle Tension: The anal sphincter is a muscle, and if it is tense or if you are unconsciously tensing it due to anxiety about pain, this can lead to discomfort. It’s important to practice relaxation techniques and ensure that you are not holding tension in that area.

3. Scar Tissue Formation: As the surgical site heals, scar tissue can form. This scar tissue can sometimes be sensitive or painful, particularly when the area is contracted. Over time, this sensitivity may decrease as the scar matures.

4. Nerve Sensitivity: Surgery can sometimes irritate or affect the nerves in the area, leading to heightened sensitivity or pain. This can manifest as discomfort during specific movements or contractions.

5. Infection or Complications: Although less common, it’s essential to rule out any complications such as infection or abscess formation. If the pain is severe, persistent, or accompanied by other symptoms such as fever, increased swelling, or discharge, it’s crucial to seek medical attention.

6. Anal Spasm: Some patients may experience anal spasms post-surgery, which can be painful. These spasms can occur in response to pain or as a reaction to the surgical trauma.

Given that you are about a month post-surgery and experiencing discomfort primarily during specific movements, it is likely that this is part of the normal healing process. However, it is always best to consult with your surgeon or healthcare provider to discuss your symptoms in detail. They can perform a physical examination to ensure that everything is healing correctly and rule out any complications.

In the meantime, here are some general recommendations to help manage your discomfort:
- Warm Baths: Soaking in a warm bath can help relax the anal muscles and alleviate pain.

- Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and inflammation.

- Gentle Exercises: Engaging in gentle pelvic floor exercises may help improve muscle control and reduce discomfort over time.

- Dietary Adjustments: Maintaining a high-fiber diet and staying hydrated can prevent constipation, which can exacerbate anal pain.

In conclusion, while some discomfort post-hemorrhoid surgery is normal, it’s essential to monitor your symptoms and communicate with your healthcare provider. They can provide personalized advice and reassurance as you continue to heal.

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