Managing Post-Surgery Itching After Fistula and Hemorrhoid Surgery

Itching may occur after fistula surgery?

Hello, doctor.
I had a fistula and hemorrhoid surgery in January this year.
The recovery has been fine, but I have been experiencing persistent anal itching, sometimes so severe that it wakes me up at night.
Are there any topical treatments available, or do I need to see a doctor? Thank you.

Ms. Shu, 30~39 year old female. Ask Date: 2019/05/20

Dr. Ke Fangxu reply Surgery

Anal itching may be caused by excessive wiping.
Applying topical hemorrhoid ointment should help alleviate the symptoms.
In addition to medication, there are three important considerations: 1.
Do not scratch to avoid causing an infection in the wound.
2.
Temporarily avoid spicy foods to prevent capsaicin from irritating the skin.
3.
Avoid using soap or body wash to clean the anal area to prevent excessive removal of the skin's natural oils.
If these measures are followed, improvement is generally seen within about a week.
If there is no improvement, it is advisable to consult a physician for evaluation and prescription medication.

Reply Date: 2019/05/20

More Info

Post-surgery itching, particularly after procedures like fistula and hemorrhoid surgeries, can be a common and frustrating issue for many patients. Itching in the anal area can arise from several factors, including irritation from surgical wounds, moisture, hygiene practices, or even the healing process itself. Here’s a comprehensive overview of the potential causes and management strategies for post-surgery itching.

Causes of Itching After Surgery
1. Healing Process: After surgery, the body goes through a natural healing process, which can involve inflammation and irritation of the surrounding tissues. This can lead to sensations of itching as the nerves in the area regenerate.

2. Irritation: Surgical sites can be sensitive and may react to various irritants, including soaps, wipes, or even the fabric of clothing. If you are using any topical medications or ointments, these could also contribute to irritation.

3. Moisture: The anal area can become moist, especially if there is any discharge from the surgical site. This moisture can lead to skin irritation and itching.

4. Hygiene Practices: Inadequate or excessive cleaning can also lead to itching. It’s important to maintain a balance in hygiene practices to avoid irritation.

5. Infection: Although less common, an infection at the surgical site can cause itching, redness, swelling, and discharge. If you notice any signs of infection, it is crucial to seek medical attention.

Management Strategies
1. Topical Treatments: Over-the-counter hydrocortisone cream can help reduce inflammation and itching. However, it is essential to use it sparingly and not for extended periods without consulting a healthcare provider. Other soothing ointments, such as zinc oxide or barrier creams, may also provide relief.

2. Sitz Baths: Taking warm sitz baths can help soothe the area, reduce irritation, and promote healing. This practice can be particularly beneficial after bowel movements.

3. Moisture Control: Keeping the area dry is crucial. You can use absorbent pads or breathable cotton underwear to help manage moisture. Avoid using heavily scented products that can irritate the skin.

4. Avoiding Irritants: Be cautious with soaps and wipes. Opt for gentle, unscented products to clean the area. Avoid scrubbing the area vigorously, as this can exacerbate irritation.

5. Dietary Considerations: A diet high in fiber can help prevent constipation and straining during bowel movements, which can aggravate the surgical site. Staying hydrated is also essential.

6. Consulting a Healthcare Provider: If the itching persists despite these measures, or if you notice any unusual symptoms such as increased pain, swelling, or discharge, it is important to consult your surgeon or a healthcare provider. They may recommend prescription medications or further evaluation to rule out complications.

Conclusion
In summary, post-surgery itching after fistula and hemorrhoid surgery can be managed through a combination of topical treatments, proper hygiene, and lifestyle adjustments. While it is often a temporary issue related to the healing process, persistent or severe itching warrants a consultation with your healthcare provider to ensure there are no underlying complications. Your comfort and recovery are paramount, so don’t hesitate to seek help if needed.

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