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, and it's quite uncomfortable.
I previously consulted a doctor who mentioned that I had injured my anal sphincter and said that there is 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: 2019/04/27

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: 2019/04/27

More Info

Post-surgery concerns, particularly after procedures like hemorrhoid and fistula surgeries, can be quite common and often distressing for patients. Your experience of increased bowel movements and discomfort, especially after such surgeries, is not unusual. The changes you are experiencing can be attributed to several factors related to the surgical procedure and the healing process.

Firstly, it is important to understand that surgeries involving the anal region, such as hemorrhoidectomy or fistulotomy, can affect the anal sphincter muscles. These muscles are responsible for controlling bowel movements, and any trauma or alteration to them during surgery can lead to changes in bowel habits. The increased frequency of bowel movements you are experiencing may be due to a combination of factors, including:
1. Sphincter Function: If the anal sphincter was damaged during surgery, it could lead to a decreased ability to control bowel movements, resulting in a feeling of urgency and increased frequency. This can also lead to a sensation of incomplete evacuation, prompting more frequent trips to the bathroom.

2. Postoperative Healing: After surgery, the body goes through a healing process that can affect bowel function. Inflammation and changes in the surrounding tissues can lead to altered bowel habits. As the surgical site heals, these symptoms may improve, but it can take time.

3. Dietary Changes: Post-surgery, patients often modify their diets to avoid discomfort, which can inadvertently lead to changes in bowel habits. A diet high in fiber is typically recommended to promote regular bowel movements, but if your diet has changed significantly, this could also contribute to your symptoms.

4. Psychological Factors: Anxiety and stress about bowel movements can also play a role in how often you feel the need to go. The fear of pain or discomfort can lead to a heightened awareness of bowel sensations, causing you to feel the urge to go more frequently.

Regarding the moist and sticky sensation you mentioned, this could be due to several reasons:
- Increased Mucus Production: After surgery, the body may produce more mucus as a protective mechanism for the healing tissues. This can lead to a feeling of wetness around the anal area.

- Hygiene Practices: Post-surgery, it is crucial to maintain proper hygiene to prevent infection and promote healing. If the area is not kept clean and dry, it can lead to discomfort and a sticky feeling.

As for whether your condition can improve, it is essential to have open communication with your healthcare provider. While some changes may be permanent due to the nature of the surgery and any damage to the sphincter, there are often management strategies that can help alleviate symptoms. These may include:
- Pelvic Floor Therapy: Working with a physical therapist who specializes in pelvic floor rehabilitation can help strengthen the muscles and improve control over bowel movements.

- Dietary Adjustments: Consulting with a nutritionist to develop a diet that supports bowel health without exacerbating symptoms can be beneficial.

- Medications: In some cases, medications may be prescribed to help manage bowel frequency and consistency.

- Follow-Up Care: Regular follow-ups with your surgeon or a gastroenterologist can help monitor your progress and make necessary adjustments to your treatment plan.

In conclusion, while the changes you are experiencing after your surgery can be concerning, it is crucial to address these issues with your healthcare provider. They can offer tailored advice and treatment options based on your specific situation. Remember, recovery from surgery can take time, and with the right support, many patients find relief from their symptoms.

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