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 I am hot or sweating, 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: 2019/04/26

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: 2019/04/26

More Info

Post-surgery concerns, especially after procedures like hemorrhoidectomy or fistula surgery, can be quite common and distressing for patients. Your experience of increased bowel movements and the inability to hold them, along with the discomfort and moisture around the anal area, is understandably concerning. Let's delve into the potential reasons for these symptoms and discuss possible management strategies.

Firstly, after surgeries involving the anal region, such as hemorrhoid or fistula surgeries, it is not uncommon for patients to experience changes in bowel habits. The anal sphincter, which is responsible for controlling bowel movements, can be affected during surgery. If the sphincter muscle is damaged or if there is swelling or inflammation post-surgery, it may lead to increased urgency and frequency of bowel movements. This can manifest as a feeling of needing to go to the bathroom more often, sometimes even when the bowel is not full.

The moisture and stickiness you describe could be attributed to several factors. Post-operative changes can lead to increased mucus production or altered anal function, which may cause a feeling of wetness. Additionally, if there is any residual inflammation or irritation in the anal area, it could contribute to discomfort and moisture.

Regarding the statement from your doctor about the injury to the anal sphincter and the lack of options for improvement, it is essential to understand that while some changes may be permanent, there are often management strategies that can help improve your quality of life. Here are some suggestions:
1. Dietary Adjustments: A high-fiber diet can help regulate bowel movements and reduce straining. Consider incorporating more fruits, vegetables, and whole grains into your meals. Staying well-hydrated is also crucial, as it can help soften stools and make bowel movements easier.

2. Pelvic Floor Exercises: Engaging in pelvic floor exercises, often referred to as Kegel exercises, can strengthen the muscles around the anal sphincter. This may help improve control over bowel movements. A physical therapist specializing in pelvic health can provide guidance on proper techniques.

3. Medications: Depending on your specific symptoms, your doctor may recommend medications to help manage bowel frequency or to address any discomfort. Antidiarrheal medications may be appropriate if you are experiencing loose stools, while stool softeners can help if you are having difficulty with hard stools.

4. Biofeedback Therapy: This is a specialized therapy that can help you gain better control over your bowel movements. It involves working with a therapist who can provide feedback on your muscle contractions and help you learn to control them more effectively.

5. Follow-Up with a Specialist: If your symptoms persist or worsen, consider seeking a second opinion from a colorectal specialist. They may offer additional insights or treatment options that could be beneficial.

6. Hygiene Practices: Maintaining good hygiene in the anal area can help prevent irritation and discomfort. Gentle cleansing with water and avoiding harsh soaps can be beneficial. Some patients find that using moist wipes instead of toilet paper can provide relief.

In conclusion, while your current situation may feel discouraging, there are often strategies and interventions that can help improve your symptoms. It is essential to maintain open communication with your healthcare provider and advocate for your needs. If you feel that your concerns are not being adequately addressed, seeking a second opinion or consulting with a specialist in colorectal health may provide you with more options for managing your post-surgical symptoms effectively.

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