Post-Surgery Recovery: Anal Changes After Hemorrhoidectomy

Recovery after hemorrhoidectomy for internal and external hemorrhoids involves several stages. Initially, patients may experience pain, swelling, and discomfort around the anal area. It is common to have some bleeding during the first few days post-surgery. Patients are usually advised to maintain a high-fiber diet and stay hydrated to prevent constipation, which can strain the surgical site

Hello, doctor.
I had hemorrhoidectomy surgery 24 days ago.
Currently, the internal hemorrhoids are no longer painful, but I still experience pain during bowel movements, and occasional constipation leads to slight bleeding.
Overall, I am recovering normally, but I have noticed two fleshy growths at the anal opening, which seem to be increasing in number.
The tissue above appears to be splitting and forming smaller fleshy growths.
Is this a normal part of the recovery process? Additionally, after my warm sitz baths in the morning and evening, I notice a green, mucus-like discharge when I wipe the anal area.
What could this be?

Niming, 30~39 year old female. Ask Date: 2020/07/25

Dr. Xu Kaixi reply Surgery

After hemorrhoid surgery, it is normal for some granulation tissue to form during the wound healing process, and this usually improves over time.
As for green discharge from the wound, it may be a mixture of wound exudate and gastrointestinal secretions.
However, if symptoms such as redness, swelling, heat, and pain occur simultaneously, it is important to consider the possibility of an infection, and it is advisable to visit a surgical outpatient clinic for further evaluation.

Reply Date: 2020/07/25

More Info

After undergoing a hemorrhoidectomy, it is common to have questions about the recovery process, especially regarding changes in the anal area. Your experience of pain during bowel movements and occasional bleeding, particularly with constipation, is not unusual in the postoperative period. However, the appearance of new tissue or "tender flesh" around the anus, as well as the presence of green, mucous-like discharge, warrants further discussion.

Understanding Post-Surgery Changes
1. Pain and Bleeding: It is typical for patients to experience some pain during bowel movements after a hemorrhoidectomy. This can be exacerbated by constipation, which is common post-surgery due to changes in diet, pain medications, or anxiety about bowel movements. It is crucial to maintain a high-fiber diet and stay hydrated to prevent constipation. If you notice blood, it should be minimal and not a cause for alarm unless it is significant or persistent.

2. Tender Flesh and New Growths: The appearance of new tissue around the anal area can be concerning. After surgery, the body goes through a healing process that may involve the formation of granulation tissue, which can appear as soft, fleshy growths. This is generally a normal part of healing. However, if these growths seem to multiply or change in appearance, it is essential to consult your surgeon. They can assess whether this is a normal healing response or if there are other underlying issues, such as the formation of skin tags or recurrence of hemorrhoids.

3. Discharge: The green, mucous-like discharge you are experiencing could be a result of several factors. It may be related to the healing process, as the body produces mucus to protect the surgical site. However, if the discharge is persistent, has a foul odor, or is accompanied by fever or increased pain, it could indicate an infection. In such cases, it is crucial to seek medical attention promptly.

Recommendations for Recovery
- Diet and Hydration: Focus on a high-fiber diet, including fruits, vegetables, and whole grains, to facilitate smooth bowel movements. Staying well-hydrated is equally important.

- Sitz Baths: Continue with warm sitz baths as they can help soothe the area and promote healing. Ensure that you gently pat the area dry afterward to avoid irritation.

- Monitoring Symptoms: Keep track of any changes in your symptoms, including the amount of pain, bleeding, or changes in discharge. If you notice any concerning signs, such as increased pain, significant bleeding, or signs of infection (fever, chills), contact your healthcare provider.

- Follow-Up Appointments: Attend all scheduled follow-up appointments with your surgeon. They will be able to assess your healing progress and address any concerns you may have.

Conclusion
While some changes after a hemorrhoidectomy can be part of the normal healing process, it is essential to remain vigilant and proactive about your recovery. If you have any doubts or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your comfort and health are paramount, and addressing any issues early can lead to a smoother recovery process.

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