Post-Surgery Concerns: Absorbable Stitches and Bowel Movements After Hemorrhoid Surgery

Postoperative suturing for hemorrhoids?

Hello Dr.
Ke, I apologize for bothering you again.
I had my third follow-up appointment 24 days post-surgery.
The doctor indicated that the sutures inside the anal canal have not yet dissolved and advised me to wait for them to fall out on their own.
Is it abnormal for the sutures to still be intact 24 days after surgery? Do absorbable sutures always dissolve on their own? If they do not dissolve, what should be done?
In the first three days post-surgery, I took a stool softener, which resulted in frequent bowel movements.
Starting on the fourth day, I stopped taking the softener and adjusted my diet to have bowel movements twice a day.
However, since the 20th day post-surgery, I have been experiencing a strong urge to defecate whenever I engage in prolonged activity, and I am able to pass stool (soft, no bleeding, taking about 5 minutes).
Is having bowel movements three times a day too frequent? Since it requires some effort, could this affect my recovery or scarring? I appreciate your guidance, thank you very much!

M, 60~69 year old female. Ask Date: 2019/05/26

Dr. Ke Fangxu reply Surgery

After hemorrhoid surgery, it is common to experience abnormal sensations for a short period of time.
During this time, there may be an increase in the frequency of bowel movements.
As long as there is no bleeding or pain, there is no need for concern; simply take warm sitz baths to help alleviate discomfort.

Reply Date: 2019/05/26

More Info

After undergoing hemorrhoid surgery, it's common to have concerns about the healing process, especially regarding absorbable stitches and bowel movements. Let's address your questions one by one.

Firstly, regarding the absorbable stitches: it is not unusual for absorbable stitches to take longer than expected to dissolve. Typically, absorbable sutures can take anywhere from a few days to several weeks to fully dissolve, depending on the type of material used and the location of the stitches. In your case, at 24 days post-surgery, it is still within the normal range for these stitches to remain intact. If the stitches do not dissolve on their own, they may need to be removed by your healthcare provider. It’s essential to follow up with your doctor if you notice any signs of infection, such as increased redness, swelling, or discharge, or if you have concerns about the stitches.

Now, regarding your bowel movements: it’s great to hear that you are managing to have soft stools without bleeding. After surgery, it’s crucial to avoid straining during bowel movements, as this can put pressure on the surgical site and potentially affect healing. The frequency of bowel movements can vary significantly from person to person. Having bowel movements three times a day may not be excessive for you, especially if they are soft and not causing discomfort. However, if you find that you are feeling the urge to go frequently, it might be worth discussing with your doctor. They can provide guidance on whether this frequency is normal for your situation or if adjustments to your diet or hydration levels are necessary.

It's also important to consider how your activity level affects your bowel movements. Increased physical activity can stimulate bowel function, which might explain the increased urge to defecate after prolonged activity. While moderate exercise is beneficial for recovery, ensure that you are not overexerting yourself, as this can lead to discomfort or complications.

In terms of recovery and scarring, gentle bowel movements are essential. Straining can lead to increased pressure in the anal area, which might hinder healing and contribute to complications such as new hemorrhoids or fissures. To promote healing, focus on maintaining a high-fiber diet, staying well-hydrated, and possibly incorporating gentle stool softeners if needed, but only under the guidance of your healthcare provider.

In summary, it is not abnormal for absorbable stitches to take time to dissolve, and if they do not fall out on their own, your doctor can assist. As for bowel movements, three times a day can be normal for some individuals, especially if they are soft and manageable. Always prioritize gentle bowel habits to support your recovery. If you have ongoing concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for further evaluation and personalized advice.

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