Post-Surgery Complications: Fecal Leakage and Pain After Hemorrhoid Surgery

Wound exudate with fecal matter?

I am six days post-surgery for hemorrhoids, but the doctor mentioned that I had a few hemorrhoids and that I actually have colonic polyps, about three of them.
The incision was made slightly above the anus.

1.
On the fourth day after the surgery, I accidentally pulled out the suture from inside the anus while having a bowel movement.
The doctor told me to cut it off, and by the fifth day, all the sutures had fallen out.
Now, the wound is in an open state, and I can see fresh tissue when I look at it.
Is this normal?
2.
Is it normal for gas to escape from both the anus and the wound?
3.
I experience excruciating pain during bowel movements, to the point of screaming and feeling weak in my legs.
For about 30 minutes afterward, my whole body trembles, and I can't speak.
Today, when I looked in the mirror, it seemed like stool was coming out of the wound as well.
Is this normal?

Lala, 20~29 year old female. Ask Date: 2018/12/11

Dr. Xu Kaixi reply Surgery

After hemorrhoid surgery, the wound may occasionally open up, resulting in an open state.
Consequently, fecal matter may come into contact with the wound, leading to contamination.
It is advised to enhance wound care by thoroughly cleaning and changing the dressing after each bowel movement.
With time, the wound should heal.
If there are concerns or fears of complications, it is recommended to return to the original surgeon's clinic for a follow-up examination.

Reply Date: 2018/12/11

More Info

After undergoing hemorrhoid surgery, it is common to experience a range of symptoms and complications, especially in the first few days post-operation. Your concerns about fecal leakage, pain, and the appearance of your surgical site are valid and warrant careful consideration.

1. Open Wound Appearance: It is not uncommon for the surgical site to appear as an open wound, especially if the stitches have dissolved or been removed. The healing process can vary significantly from person to person. In many cases, the wound may initially look raw or "fleshy" as it heals. However, it is crucial to keep the area clean and follow your doctor's post-operative care instructions to prevent infection. If you notice increased redness, swelling, or discharge, you should contact your healthcare provider.

2. Passing Gas from the Wound: Experiencing gas escaping from both the anus and the surgical site can be concerning. This may indicate that the surgical site is still healing and that there is some degree of communication between the rectum and the wound. While it can be normal to feel some air passing through the area, if this is accompanied by pain or unusual discharge, it is essential to consult your doctor. They may want to assess whether there is any abnormality or complication, such as a fistula, which is an abnormal connection between the rectum and the skin.

3. Severe Pain During Bowel Movements: The pain you describe during bowel movements is a significant concern. It is not uncommon to experience discomfort after hemorrhoid surgery, especially if the area is still healing. However, if the pain is so severe that it causes you to scream or feel faint, this may indicate a complication such as anal fissures or excessive tension in the anal sphincter. It is crucial to communicate this pain to your healthcare provider, as they may need to evaluate your healing process and possibly prescribe pain management strategies or recommend dietary changes to soften your stool.

4. Fecal Leakage: If you feel that fecal matter is coming from the surgical site, this is not typical and should be addressed immediately. It could indicate a problem with the surgical repair or healing process. You should reach out to your surgeon or healthcare provider to discuss this symptom, as they may need to examine you to ensure that everything is healing correctly.

Additional Considerations
- Post-Surgery Care: After hemorrhoid surgery, it is essential to maintain a high-fiber diet and stay well-hydrated to prevent constipation, which can exacerbate pain during bowel movements. Over-the-counter stool softeners may also be recommended to ease the process.

- Pain Management: If you are experiencing significant pain, your doctor may prescribe medications to help manage it. It is important to take pain relief as directed and to follow up with your healthcare provider if the pain persists or worsens.

- Follow-Up Appointments: Regular follow-up appointments with your surgeon are crucial to monitor your healing process. If you have not already scheduled a follow-up, it is advisable to do so, especially given the symptoms you are experiencing.

In summary, while some discomfort and unusual sensations can be part of the healing process after hemorrhoid surgery, the severity of your symptoms warrants further evaluation. Do not hesitate to reach out to your healthcare provider to discuss your concerns and ensure that you are on the right path to recovery.

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