Persistent Anal Swelling After Hemorrhoid Surgery: What Could It Be?

Q: Persistent Anal Swelling After Hemorrhoid Surgery: What Could It Be?

Hello： Straining can indeed cause localized varicose veins to expand, but they disappear when you stop straining after a bowel movement. <br>Changhua Hospital cares about your health. <br>Dr. <br>Tsai An-shun.

Hemorrhoids are difficult to locate, but there is a noticeable swelling?

This year, I underwent rubber band ligation surgery and the doctor mentioned that three internal hemorrhoids were treated.
However, I still feel a lump at the anal opening during bowel movements.
When I went to see the doctor, he said he couldn't feel anything and suggested that it might be a stage II hemorrhoid, which could be unpalpable after defecation due to blood flow returning.
I would like to know if a larger hospital would be able to diagnose this.
Since it's located right at the anal opening, it seems unlikely that it can't be felt.
Could it be something other than hemorrhoids?

Zeng Jingxuan, 10~19 year old female. Ask Date: 2018/11/01

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Straining can indeed cause localized varicose veins to expand, but they disappear when you stop straining after a bowel movement.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2018/11/01

More Info

Persistent anal swelling after hemorrhoid surgery can be concerning and may stem from various causes. After undergoing a rubber band ligation procedure for internal hemorrhoids, it is not uncommon for patients to experience some residual swelling or discomfort. However, if you are noticing a persistent lump or swelling at the anal region, it is essential to consider several possibilities.

Firstly, the swelling could be due to residual inflammation or edema following the surgical procedure. Hemorrhoid surgeries, including rubber band ligation, can lead to temporary swelling as the tissues heal. This is generally a normal part of the recovery process, but if the swelling persists beyond a few weeks or worsens, further evaluation may be warranted.

Another possibility is the development of a thrombosed external hemorrhoid. Sometimes, even after treating internal hemorrhoids, external hemorrhoids can form or become exacerbated. A thrombosed hemorrhoid can present as a painful lump near the anal opening and may require additional treatment if it does not resolve on its own.

Additionally, the swelling could be indicative of a perianal abscess or fistula. An abscess is a localized collection of pus that can occur due to infection, while a fistula is an abnormal connection between the anal canal and the skin. Both conditions can cause swelling and discomfort and may require surgical intervention.

It is also important to consider the possibility of skin tags, which can develop after hemorrhoid surgery. Skin tags are benign and often painless, but they can be mistaken for other conditions if they become irritated or inflamed.

Given that your doctor was unable to palpate the swelling during the examination, it may be beneficial to seek a second opinion or further evaluation at a larger medical facility. Advanced imaging techniques, such as an ultrasound or MRI, can provide more insight into the underlying cause of the swelling. A thorough examination by a specialist in colorectal surgery or gastroenterology may also help clarify the diagnosis.

In the meantime, it is crucial to monitor your symptoms. If you experience increased pain, bleeding, or changes in bowel habits, you should seek medical attention promptly. Maintaining a high-fiber diet and staying well-hydrated can help ease bowel movements and reduce strain, which may alleviate some discomfort.

In summary, while persistent anal swelling after hemorrhoid surgery can be due to various factors, it is essential to follow up with a healthcare provider for a comprehensive evaluation. This will help ensure that any underlying issues are addressed and that you receive appropriate treatment to promote healing and comfort.

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