Post-Fistula Surgery: Recovery Concerns and Pain Management

Post-fistula surgery

Hello Doctor, I underwent a fistula surgery on December 20, 2018, where the surgical method involved cutting the sphincter muscle.
After the surgery, I noticed a piece of tissue around the anus that was cut and has sunken in.
Around early February, I returned to the clinic due to discharge, and the doctor mentioned that the fistula is located deep, so the recovery time would be prolonged.
I would like to ask: 1.
Will the tissue that was cut around the anus grow back? Currently, after bowel movements, there is still some discharge flowing from that gap, indicating that I haven't fully emptied my bowels.
2.
Is it normal for that area to occasionally feel sharp pain after bowel movements? 3.
Can I engage in normal physical activities like running at this stage? Thank you for your answers, Doctor.

Feng, 20~29 year old female. Ask Date: 2019/02/23

Dr. Chen Jiaming reply Surgery

1.
Will gradually grow.

2.
Normal.

3.
If it does not provoke pain, you can gradually start exercising.

Reply Date: 2019/02/23

More Info

Post-fistula surgery recovery can be a challenging process, and it's understandable to have concerns about your healing and pain management. Based on your description, here are some insights and recommendations regarding your recovery.

1. Healing of the Incision Site: After a fistula surgery, especially one involving the anal sphincter, it is common for the incision site to take time to heal. The area you described as a "depression" or "defect" may indeed fill in over time, but this process can vary significantly from person to person. The healing of soft tissue in this area can be slow, particularly if the fistula was deep or complex. Your surgeon's assessment that the recovery time is prolonged due to the depth of the fistula is consistent with typical outcomes. It is essential to maintain good hygiene in the area to prevent infection, which can further delay healing.

2. Post-operative Pain and Discomfort: Experiencing occasional sharp pain or discomfort at the incision site after bowel movements can be normal, especially in the early stages of recovery. This pain may be due to the sensitivity of the healing tissue or irritation from bowel movements. If the pain is severe or worsening, it is crucial to consult your healthcare provider to rule out complications such as infection or improper healing. They may recommend pain management strategies, including over-the-counter pain relievers or topical treatments to soothe the area.

3. Physical Activity and Exercise: Regarding your question about resuming normal activities like running, it is generally advisable to avoid high-impact exercises until you have fully healed. Engaging in activities that put strain on the pelvic area or involve significant movement can exacerbate pain or lead to complications. It is best to follow your surgeon's advice on when to resume physical activities. They may suggest starting with gentle exercises, such as walking or stretching, and gradually increasing intensity as tolerated.

Additional Recommendations for Recovery:
- Dietary Adjustments: To ease bowel movements and reduce strain on the surgical site, consider a high-fiber diet and adequate hydration. This can help prevent constipation, which can lead to straining during bowel movements and increase discomfort.

- Sitz Baths: Taking warm sitz baths can help soothe the area, reduce pain, and promote healing. This practice can also help keep the area clean and comfortable.

- Follow-Up Appointments: Regular follow-ups with your surgeon are crucial to monitor the healing process. They can assess the incision site and provide tailored advice based on your recovery progress.

- Pain Management: If over-the-counter medications are insufficient for pain relief, discuss this with your healthcare provider. They may prescribe stronger pain relief options or recommend other therapies, such as physical therapy, to help manage discomfort.

- Mental Health Considerations: Chronic pain and recovery challenges can take a toll on mental health. If you find yourself feeling anxious or depressed about your recovery, consider speaking with a mental health professional who can provide support.

In conclusion, while some discomfort and concerns are normal after fistula surgery, it is essential to maintain open communication with your healthcare provider. They can provide personalized guidance and interventions to help you navigate your recovery effectively. Always prioritize your health and well-being, and do not hesitate to seek help when needed.

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