Post-PPH Surgery: Bleeding and Healing at the Anus - Surgery

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After undergoing a PPH (Procedure for Prolapse and Hemorrhoids) surgery, it is not uncommon to experience some bleeding and discomfort during the healing process. The PPH procedure is designed to treat internal hemorrhoids by removing excess tissue and ligating the blood vessels that supply the hemorrhoids. While the surgery is generally considered less painful than traditional hemorrhoidectomy, it still involves surgical trauma, and the healing process can vary from person to person.

In your case, experiencing bleeding from the surgical site 20 days post-operation, especially after a hard bowel movement, can be concerning but may not be entirely unusual. The fact that you had a significant bleeding episode after straining during a bowel movement indicates that the surgical site may still be sensitive and healing. It is important to note that any trauma to the area, including straining, can lead to minor bleeding, especially if the tissue is still fragile.

The presence of bright red blood after bowel movements can be indicative of several things. If the bleeding is minimal and resolves quickly, it may simply be a sign of irritation or minor trauma to the healing tissue. However, if the bleeding persists, increases in volume, or is accompanied by severe pain, it could suggest a complication such as a reopening of the surgical site or even an infection.

Infections at the surgical site can occur, although they are relatively rare. Signs of infection may include increased redness, swelling, warmth around the area, discharge of pus, or a fever. If you notice any of these symptoms, it is crucial to seek medical attention promptly.
To promote healing and minimize the risk of further bleeding, consider the following recommendations:
1. Dietary Adjustments: Ensure you are consuming a high-fiber diet to soften your stools and reduce straining during bowel movements. Adequate hydration is also essential. Foods such as fruits, vegetables, whole grains, and legumes can help.

2. Stool Softeners: If you are still experiencing hard stools, consider using over-the-counter stool softeners or fiber supplements as recommended by your healthcare provider.

3. Gentle Bowel Movements: Avoid straining during bowel movements. If you feel the urge to go, try to respond promptly rather than holding it in, which can lead to harder stools.

4. Sitz Baths: Regular sitz baths can help soothe the area and promote healing. Soaking in warm water for 10-15 minutes several times a day can provide relief.

5. Avoid Heavy Lifting and Strenuous Activities: For at least a few weeks post-surgery, avoid heavy lifting and strenuous activities that could put pressure on the surgical site.

6. Follow-Up Appointments: Keep all follow-up appointments with your surgeon or healthcare provider. They can monitor your healing process and address any concerns you may have.

7. Medication: If you are experiencing pain, discuss with your healthcare provider about appropriate pain management options.

In summary, while some bleeding and discomfort can be expected after PPH surgery, persistent or increasing symptoms warrant further evaluation by your healthcare provider. It is essential to monitor your symptoms closely and maintain open communication with your medical team to ensure a smooth recovery. If you have any doubts or concerns, do not hesitate to reach out to your surgeon for personalized advice and care.