Post-Surgery Care for Fistula and Hemorrhoids: Your Questions Answered - Surgery

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Fistula and hemorrhoid surgery follow-up questions?


Hello, doctor.
I would like to ask about my situation.
I was admitted for a fistula surgery yesterday, and the doctor mentioned that they would also remove part of my hemorrhoids.
They said that if too much is removed at once, it could cause anal stenosis.
I have previously experienced issues where a lump would protrude after bowel movements, and I had to push it back in with my finger.
Now, three days post-surgery, I have been eating soft foods, which seems to have caused the lump to protrude again.
I am hesitant to push it back in because the surgical site is painful, but it feels like it is rubbing against the fistula wound, causing a stinging and burning sensation in the entire anal area.
Should I push the lump back in, or should I wait until the surgical site is no longer painful before addressing it? Thank you, doctor, for taking the time to answer my questions.

Miss Hsu, 30~39 year old female. Ask Date: 2019/01/15

Dr. Ke Fangxu reply Surgery


This situation may simply be swelling of the wound, but it is also possible that the hemorrhoidal tissue was not completely excised.
However, it is currently not recommended to push it back in, as this could increase pain at the site and there is no guarantee it won't protrude again.
It is advisable to take warm sitz baths to help reduce swelling and then observe any subsequent changes.
Applying topical ointments can also help alleviate symptoms.

Reply Date: 2019/01/15

More Info


After undergoing surgery for a fistula and hemorrhoids, it is essential to follow proper post-operative care to ensure a smooth recovery and minimize complications. Here are some key considerations and recommendations based on your situation:

1. Managing Pain and Discomfort
Post-surgery, it is common to experience pain, especially around the surgical site. If you are feeling a burning or stinging sensation, it is crucial to manage this discomfort effectively. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help alleviate pain. However, always consult your physician before taking any medication to ensure it is safe for your specific condition.


2. Handling the "Meatball" (Prolapsed Tissue)
You mentioned experiencing a "meatball" or prolapsed tissue after bowel movements. It is essential to avoid pushing it back in if it causes pain or discomfort. Doing so could exacerbate your pain and potentially harm the surgical site. Instead, focus on gentle care. If the tissue is not causing severe pain or complications, it may be best to wait until your surgical site has healed sufficiently before attempting to reposition it.

3. Bowel Movements and Diet
Soft stools are vital after surgery to prevent straining during bowel movements, which can lead to complications. Ensure you are consuming a high-fiber diet, including fruits, vegetables, and whole grains, to promote regular and soft bowel movements. Staying hydrated is equally important, so drink plenty of fluids. If you find that your current diet is not yielding the desired results, consider discussing dietary adjustments with your healthcare provider.


4. Hygiene Practices
Maintaining proper hygiene is crucial to prevent infection, especially around the surgical site. After bowel movements, consider using a sitz bath or gently rinsing the area with warm water. Avoid using harsh soaps or scrubbing the area, as this can irritate the skin and the surgical site. Pat the area dry with a clean towel or allow it to air dry.


5. Activity Level
Limit physical activity during the initial recovery phase. Avoid heavy lifting, strenuous exercise, or any activity that puts pressure on your abdominal area. Gradually increase your activity level as you feel more comfortable, but always listen to your body. If you experience increased pain or discomfort, it may be a sign to slow down.


6. Follow-Up Appointments
It is crucial to attend all follow-up appointments with your surgeon. These visits allow your physician to monitor your healing progress and address any concerns you may have. If you notice any signs of infection, such as increased redness, swelling, or discharge from the surgical site, contact your healthcare provider immediately.


7. Emotional Well-being
Surgery can be a stressful experience, and it is essential to take care of your emotional health as well. Engage in activities that promote relaxation and stress relief, such as deep breathing exercises, meditation, or gentle yoga, as tolerated.


Conclusion
In summary, after your fistula and hemorrhoid surgery, prioritize pain management, proper hygiene, and a fiber-rich diet to facilitate healing. Avoid pushing back any prolapsed tissue if it causes pain, and consult your healthcare provider for personalized advice. Regular follow-ups are essential to ensure a smooth recovery. Remember, healing takes time, so be patient with yourself as you recover. If you have any further questions or concerns, do not hesitate to reach out to your healthcare team.

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