Post-Surgery Concerns After Anal Abscess and Fistula Procedure: Expert Advice Needed

Please consult with your physician regarding post-operative issues related to drainage tube placement?

I underwent surgery for an anal abscess and a mild fistula at China Medical University in Taichung on November 6th.
Today is the fifth day post-operation, and I would like to ask the physician a few questions regarding my recovery:
1.
If I experience frequent diarrhea after taking medication, which causes severe pain at the wound site, should I continue taking it? I initially suspected it was due to the stool softener, but I later found that I still have diarrhea even without it.
What should I do?
2.
There is a mark on the outside of my anus (about 1 cm) that resembles a post-operative scar and is slightly painful.
Is this normal?
3.
I currently have little to no blood, but I have started to notice a yellowish fluid seeping out.
Is this normal?
4.
Is it okay to sit and use the computer after the surgery, or should I only lie down?
5.
The doctor has prescribed me an antibiotic ointment called "Shih-Pi-Hsin." Should I apply this ointment after each bowel movement? Does it need to be inserted into the anus for application?
I apologize for the many questions and appreciate your help in clarifying these concerns.
Thank you very much!

Youzi, 30~39 year old female. Ask Date: 2019/11/10

Dr. Ke Fangxu reply Surgery

1.
Laxatives are prescribed to prevent postoperative constipation; if diarrhea occurs, the dosage should be reduced or the medication should be discontinued.

2.
Based on this description alone, it is not possible to determine whether it is related to the surgery; a consultation with the surgeon is necessary for confirmation.

3.
It is normal to have slight drainage before the wound is completely healed; it typically takes about a month for there to be no discharge.

4.
You can sit, but avoid prolonged periods; it is advisable to get up and walk around every 1-2 hours.

5.
Ointments are generally recommended for external application; intentionally inserting them into the rectum may cause harm to the wound.

Reply Date: 2019/11/10

More Info

After undergoing surgery for an anal abscess and a minor fistula, it's understandable to have concerns about your recovery and any symptoms you may be experiencing. Here’s a comprehensive response to your questions based on medical knowledge and best practices:
1. Diarrhea and Pain Management: If you are experiencing frequent diarrhea after taking medication, it is crucial to assess the cause. Diarrhea can indeed be a side effect of certain medications, including antibiotics or stool softeners. If the diarrhea is severe and causing significant pain at the surgical site, you should consult your physician before continuing the medication. They may recommend adjusting the dosage or switching to a different medication that is less likely to cause gastrointestinal upset. Staying hydrated is also essential, especially if you are experiencing diarrhea.

2. Post-Surgical Scarring and Pain: It is common to have some pain and tenderness at the surgical site as it heals. The scar you mentioned, approximately 1 cm in size, could be a normal part of the healing process. However, if the pain worsens or if you notice any signs of infection (such as increased redness, swelling, or discharge), you should contact your healthcare provider. They can evaluate whether this is a normal part of recovery or if further intervention is needed.

3. Discharge from the Surgical Site: The presence of a yellowish liquid oozing from the surgical site can be concerning. It may be a sign of normal healing, as some drainage is expected after such procedures. However, if the discharge has a foul odor, is accompanied by increased pain, or if you develop a fever, these could be signs of an infection, and you should seek medical attention promptly.

4. Sitting and Activity Post-Surgery: After surgery for an anal abscess and fistula, it is generally advisable to avoid prolonged sitting, especially on hard surfaces, as this can increase pressure on the surgical site and cause discomfort. If you need to use a computer, consider using a cushion or a specialized seat that relieves pressure on the area. Alternating between sitting and lying down may help manage discomfort.

5. Use of Antibiotic Ointment: The antibiotic ointment prescribed (such as "使皮新") is typically applied to the surgical area after each bowel movement to prevent infection and promote healing. You should apply it to the external area around the anus, and if instructed by your doctor, you may also need to apply it internally. However, be gentle to avoid causing further irritation or pain. If you are unsure about the application technique, it’s best to consult your healthcare provider for specific instructions.

In conclusion, while some discomfort and symptoms are normal after surgery for an anal abscess and fistula, it is essential to monitor your recovery closely. If you experience worsening symptoms, signs of infection, or have any concerns about your healing process, do not hesitate to reach out to your healthcare provider for guidance. They can provide personalized advice based on your specific situation and ensure that you are on the right track to recovery.

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