Post-Surgery Concerns: Managing Symptoms After Hemorrhoid Surgery

Post-hemorrhoid surgery

Hello, I underwent surgery for hemorrhoids (stage III mixed hemorrhoids) at Chang Gung Memorial Hospital on September 20.
After finishing the medication from Chang Gung on September 30, I noticed that my bowel movements have been loose and unformed since the surgery.
Today, October 2, I am concerned whether this condition could lead to anal stenosis or affect the healing of the wound.
Additionally, when I feel a strong urge to defecate, I must rush to the restroom, or I experience a sensation of impending incontinence.
I also feel small lumps and swelling around the anus.
The doctor during my follow-up visit did not provide much information, only stating that it would gradually subside, but I find it quite large and am unsure if it will really go away.
Furthermore, there is some discharge from the wound, and I am a bit confused about whether it is discharge or fecal matter, which is quite distressing for me.

Chang, 30~39 year old female. Ask Date: 2019/10/02

Dr. Ke Fangxu reply Surgery

After hemorrhoid surgery, doctors typically prescribe stool softeners to prevent constipation.
If bowel movements are too loose, it is recommended to discontinue the stool softeners.
Symptoms of anal stenosis include difficulty in bowel movements accompanied by pain.
Your situation does not appear to be swelling from the surgical site; the presence of small tissue tags is normal and will improve as the wound heals and swelling decreases.
There will be discharge until the wound is completely healed.
Regular warm sitz baths should help, and using pads can prevent soiling of clothing.

Reply Date: 2019/10/02

More Info

After undergoing hemorrhoid surgery, particularly for advanced mixed hemorrhoids, it is not uncommon to experience a variety of symptoms as your body heals. Your concerns regarding loose stools, the sensation of urgency, and the presence of discharge are valid and warrant a thorough understanding of the healing process and potential complications.

Firstly, it is important to recognize that changes in bowel habits, such as experiencing loose stools or diarrhea, can occur post-surgery. This can be due to several factors, including dietary changes, the effects of anesthesia, or medications taken during and after the procedure. If you have recently completed a course of medication, it is possible that your digestive system is still adjusting. Loose stools alone are unlikely to cause anal stenosis (narrowing of the anal canal), but if this condition persists, it could lead to complications, including difficulty in bowel movements or increased straining, which may affect the surgical site.

The sensation of urgency and the feeling of impending incontinence can be distressing. This may be related to the surgical manipulation of the anal area, which can temporarily alter the normal function of the anal sphincters. As your body heals, these sensations should gradually improve. However, if they persist or worsen, it is crucial to communicate this with your healthcare provider.

Regarding the "small flesh ball" and swelling you are experiencing, this could be a normal part of the healing process. Post-surgical swelling and the formation of granulation tissue can occur as the body repairs itself. While your doctor has indicated that this will likely resolve over time, it is essential to monitor the size and symptoms associated with it. If the swelling increases, becomes painful, or if you notice any signs of infection (such as increased redness, warmth, or discharge), you should seek medical attention promptly.

The presence of discharge can be concerning, especially if you are unsure whether it is normal post-operative discharge or fecal matter. It is common to have some discharge after hemorrhoid surgery, which may include blood-tinged fluid or mucus as the surgical site heals. However, if the discharge is foul-smelling or accompanied by other symptoms such as fever or increased pain, this could indicate an infection, and you should contact your physician immediately.

In summary, while some of the symptoms you are experiencing can be typical after hemorrhoid surgery, it is essential to maintain open communication with your healthcare provider. They can provide reassurance, evaluate your symptoms, and determine if any further intervention is necessary. Keeping a record of your symptoms, including bowel habits, any changes in the size of the swelling, and the nature of the discharge, can be helpful for your follow-up appointments. Additionally, maintaining a high-fiber diet, staying hydrated, and following any post-operative care instructions provided by your surgeon can aid in your recovery and help prevent complications.

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