Post-Surgery Concerns: Managing Increased Bowel Movements and Discomfort

Postoperative care for anal fistula surgery?

Last August, after undergoing surgery for hemorrhoids and a fistula, I noticed an increase in my bowel movements; I feel the urge to defecate frequently and cannot hold it in.
Additionally, whenever it's hot or I sweat, my anus feels moist and sticky.
I previously consulted a doctor who mentioned that I had injured my anal sphincter and said there was no way to improve the situation.
I would like to know if my current condition truly cannot be improved.

Xiao Qi, 20~29 year old female. Ask Date: 2019/04/25

Dr. Ke Fangxu reply Surgery

If the damage to the sphincter is due to surgery, the possibility of undergoing sphincteroplasty depends on the extent of the injury.
The effectiveness of this procedure is related to the degree of damage.
It is advisable to consult a colorectal surgeon for an evaluation, as this type of surgery is typically performed by specialists in this field.
However, it is important to note that there is no guarantee that the surgery will completely restore anal function; it may only improve the current symptoms to some extent.

Reply Date: 2019/04/25

More Info

Post-surgery concerns, particularly after procedures like hemorrhoid and fistula surgeries, can be quite common and distressing for patients. Your experience of increased bowel movements and discomfort is not unusual, especially if there has been any trauma to the anal sphincter muscles during surgery.
After surgeries involving the anal region, such as hemorrhoidectomy or fistulotomy, patients may experience changes in bowel habits. This can include an increase in the frequency of bowel movements, urgency, and sometimes even incontinence. These changes can be attributed to several factors:
1. Sphincter Damage: As your doctor mentioned, if the anal sphincter was injured during the procedure, it could lead to difficulties in controlling bowel movements. The sphincter muscles are crucial for maintaining continence, and any damage can result in increased urgency or frequency of bowel movements.

2. Inflammation and Healing: Post-surgical inflammation can also contribute to changes in bowel habits. The body’s healing process can affect how the intestines function, leading to increased bowel movements or discomfort.

3. Dietary Changes: After surgery, patients often modify their diets, either consciously or unconsciously, which can affect bowel habits. A diet high in fiber can lead to more frequent bowel movements, while a low-fiber diet can cause constipation and straining, which may exacerbate discomfort.

4. Psychological Factors: Anxiety about bowel movements after surgery can also play a role. Patients may feel more urgency or discomfort due to fear of pain or complications, leading to a cycle of increased bowel movements.

Regarding your specific situation, it’s important to have an open dialogue with your healthcare provider. While your doctor has indicated that the damage to the anal sphincter may not be reversible, there are still management strategies that can help improve your quality of life:
- Pelvic Floor Therapy: Engaging in pelvic floor rehabilitation with a specialized physical therapist can help strengthen the pelvic muscles and improve control over bowel movements.

- Dietary Adjustments: Maintaining a balanced diet rich in fiber can help regulate bowel movements. However, if you are experiencing diarrhea or frequent urges, it may be beneficial to consult a dietitian to tailor your diet to your current needs.

- Medications: There are medications available that can help manage symptoms, including antidiarrheal medications or medications that can help regulate bowel function.

- Biofeedback Therapy: This is a technique that can help you gain more control over your bowel movements by teaching you how to relax and coordinate the muscles involved in bowel control.

- Surgical Options: In some cases, if the symptoms are severe and significantly impact your quality of life, further surgical options may be considered to repair any damage or improve function.

In conclusion, while your current situation may seem challenging, there are various avenues for management and improvement. It is essential to continue communicating with your healthcare provider about your symptoms and concerns. They can help you explore the best options tailored to your specific situation, ensuring that you receive the support and care you need during your recovery.

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