Post-Surgery Anal Pain: Causes and Solutions After External Hemorrhoid Removal

One year after external mole removal, there is swelling and pain in the anal area?

A year after the external hemorrhoid surgery, there is swelling and pain around the anal area extending to the thigh, which occurs intermittently after standing or sitting for about 5 minutes.
Daily warm sitz baths and topical ointments have not improved the condition, and only lying down alleviates the swelling and pain.
It has been noticed that there is excess skin around the anal area that has increased in size since the initial surgery.
There are also occasional sensations of a foreign body at the anal opening, similar to the feelings experienced when the external hemorrhoid was present.
Discomfort arises from prolonged walking or sitting, raising the question of whether this is related to poor blood circulation or if it could be a new hemorrhoid.
Additionally, sitting on bicycle seats is uncomfortable.
This is the second hemorrhoid surgery.
Are there any methods to improve this condition, and is surgery necessary? Thank you.

Xiao Ke, 40~49 year old female. Ask Date: 2019/02/21

Dr. Ke Fangxu reply Surgery

This situation is actually more akin to the symptoms of a herniated disc, commonly referred to as bone spur compression of the sacral nerve roots.
Symptoms like these would not typically arise from hemorrhoid surgery.
I recommend that you first consult with your surgeon to check for any recurrence of hemorrhoids.
You might consider trying topical medications for treatment.
Additionally, please consult a neurologist to investigate whether there is an issue with a herniated disc.

Reply Date: 2019/02/21

More Info

After undergoing external hemorrhoid removal, experiencing anal pain and discomfort can be quite distressing. Your symptoms, including swelling and pain radiating to the thigh, suggest a few potential causes that may need to be addressed.

Firstly, it is important to consider that after any surgical procedure, especially one involving the anal region, there can be a range of expected post-operative symptoms. These can include pain, swelling, and even the sensation of a foreign body, particularly if there is residual tissue or skin tags (also known as "excess skin") left after the surgery. The presence of these skin tags can sometimes lead to discomfort and may feel similar to the original hemorrhoidal tissue, especially if they become irritated.

The fact that your pain is alleviated when lying down but exacerbated by sitting or standing for prolonged periods suggests that your symptoms may be related to pressure on the surgical site. This could be due to inflammation or irritation of the surrounding tissues. Additionally, if you have developed new hemorrhoids, which can occur after surgery due to changes in blood flow or pressure in the anal region, this could also contribute to your discomfort.

Another possibility is that you may be experiencing a condition known as "chronic anal pain," which can occur after surgery due to nerve irritation or damage. This type of pain can be persistent and may not respond well to standard treatments. It is also essential to consider the role of blood circulation; if there is any compromise in blood flow to the area, it could exacerbate pain and swelling.

To manage your symptoms, here are some recommendations:
1. Warm Sitz Baths: Continue with warm sitz baths, as they can help soothe the area and promote healing. Ensure that the water is not too hot, as this can cause further irritation.

2. Topical Treatments: If you are using a topical ointment, ensure it is suitable for post-operative care. Some creams can cause irritation, so it may be worth consulting your doctor about alternatives.

3. Pain Management: Over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage pain. However, consult your doctor before taking any medication, especially if you have other health conditions or are on other medications.

4. Avoid Straining: Ensure that you are not straining during bowel movements. A high-fiber diet and adequate hydration can help prevent constipation and reduce the risk of straining.

5. Follow-Up with Your Surgeon: Given that your symptoms have persisted for a year and are affecting your quality of life, it is crucial to follow up with your surgeon or a specialist in colorectal surgery. They can assess whether there are any complications from the surgery, such as the formation of new hemorrhoids or other issues that may require intervention.

6. Consider Physical Therapy: In some cases, pelvic floor physical therapy can be beneficial for managing chronic pain in the anal region. A physical therapist specialized in this area can provide exercises and techniques to alleviate discomfort.

7. Surgical Options: If conservative measures do not provide relief and if there is evidence of new hemorrhoids or other complications, further surgical intervention may be necessary. Your surgeon can discuss the risks and benefits of any potential procedures.

In conclusion, while your symptoms may be related to the surgical site and surrounding tissues, a thorough evaluation by a healthcare professional is essential to determine the exact cause and appropriate treatment. Do not hesitate to seek medical advice, as timely intervention can significantly improve your quality of life.

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