Post-Surgery Concerns: Managing Swelling and Cream Irritation After Hemorrhoid Surgery

Post-operative swelling around the hemorrhoid surgery site and ointment?

Hello, doctor.
I recently had surgery for hemorrhoids (sentinel pile) at the end of January due to discomfort and pain.
According to my attending physician, the sentinel pile was caused by my pre-existing anal fissure.
However, it has been a month since the surgery, and I can still feel a lump around the anal area.
If you don't mind, you can refer to the image here: https://imgur.com/a/1UOe88Z.

Initially, after the surgery, I was advised to take warm sitz baths and apply ointment.
My attending physician also confirmed the wound during a follow-up visit and instructed me to switch to Elmomet cream (mometasone furoate) after the third week.
However, I have noticed that this cream causes a burning sensation each time I apply it.
Could this be because I still have broken skin and an open wound? Should I switch back to the ointment? Additionally, how long does it typically take for the lump (I'm not sure if it's excess skin or a lump) to subside? Sometimes, it becomes uncomfortable when walking due to friction.
😭 I am currently abroad and won't be returning to Taiwan in the short term, so I would like to consult with you.

Aidi, 20~29 year old female. Ask Date: 2020/03/02

Dr. Ke Fangxu reply Surgery

Elomet is a potent corticosteroid ointment, and your physician may have prescribed this medication for specific reasons.
Please consult your doctor for detailed information.
If you are unable to contact your physician in the short term, it is advisable to take warm sitz baths in the meantime.

Reply Date: 2020/03/02

More Info

After undergoing hemorrhoid surgery, it is not uncommon for patients to experience lingering symptoms such as swelling and irritation at the surgical site. Your concerns regarding the persistent lump around the anal area, as well as the burning sensation from the Elmomet cream (mometasone furoate), are valid and warrant a careful approach to management.

Firstly, it is important to understand that post-surgical swelling can occur as part of the healing process. The body responds to surgery by sending blood and fluids to the area to promote healing, which can lead to swelling. This is typically a normal response, but if the swelling persists beyond a few weeks or is accompanied by increased pain, redness, or discharge, it may indicate a complication such as infection or improper healing.

Regarding the lump you are feeling, it could be a few different things. It might be a residual swelling from the surgery, scar tissue, or even a small amount of excess skin (often referred to as a skin tag) that can develop after hemorrhoid surgery. Skin tags can sometimes form as a result of the surgical procedure, especially if there was significant tissue manipulation. These can be benign and may not require treatment unless they become bothersome.

The burning sensation you are experiencing after applying the Elmomet cream could be due to several factors. Mometasone furoate is a topical corticosteroid that can help reduce inflammation and itching, but it can also cause irritation, especially if there are open wounds or broken skin at the application site. If you have any broken skin or if the area is still healing, it might be best to discontinue the use of this cream temporarily and revert to a more soothing ointment, such as a barrier cream or a simple emollient that can help protect the area without causing irritation.

In terms of the timeline for swelling and the lump to resolve, it can vary significantly from person to person. Generally, swelling should start to decrease within a few weeks post-surgery, but complete resolution can take longer, sometimes several months. If the lump does not decrease in size or if it becomes painful, it would be advisable to seek medical attention, even if you are currently abroad. A healthcare provider can assess the area and determine if any further intervention is necessary.

While you are unable to return to Taiwan in the short term, consider reaching out to a local healthcare provider who can evaluate your condition. They may be able to provide you with alternative treatments or medications that are suitable for your situation. Additionally, maintaining good hygiene, using warm sitz baths, and avoiding any irritants in the area can help promote healing.

In summary, while some swelling and irritation can be expected after hemorrhoid surgery, persistent symptoms should be evaluated by a healthcare professional. If the burning sensation from the cream continues or worsens, consider switching to a gentler product. Lastly, monitor the lump closely, and if it does not improve or causes discomfort, seek medical advice as soon as possible. Your health and comfort are paramount, and addressing these concerns promptly can help ensure a smoother recovery.

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