Post-Hemorrhoid Surgery: Common Concerns and Pain Management - Surgery

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Postoperative Questions Regarding Hemorrhoid Surgery


Hello, doctor.
It has been four days since my external hemorrhoidectomy, and I am still experiencing unbearable pain.
The area around the wound is swollen around half of the anus.
I have been lying in bed and relying on painkillers to manage my daily activities.
However, I read that this type of outpatient surgery is not that serious, yet I am unable to return to work for several days.
During bowel movements, the swelling around the anal area is obstructing, causing significant pain.
The doctor mentioned that this is all normal, but I am also experiencing some bleeding and a foul-smelling discharge; is this normal as well? After the surgery, I was only prescribed painkillers, and my next follow-up appointment is still several days away.
Could you please recommend an ointment that might help the wound heal faster?

Niming, 20~29 year old female. Ask Date: 2020/10/16

Dr. Ke Fangxu reply Surgery


Personally, I have not undergone outpatient hemorrhoidectomy because postoperative swelling and pain are inevitable.
Mild bleeding and discharge are also considered normal.
During this time, it is not recommended to apply ointments to avoid compromising wound cleanliness.
Frequent warm sitz baths can help reduce swelling, and it is also important to prevent constipation and avoid prolonged sitting.

Reply Date: 2020/10/16

More Info


Post-hemorrhoid surgery pain management and recovery can indeed be challenging, especially in the first few days following the procedure. It is not uncommon for patients to experience significant discomfort, swelling, and even some discharge from the surgical site. Here’s a comprehensive overview of what you might expect and how to manage your symptoms effectively.


Common Concerns After Hemorrhoid Surgery
1. Pain and Discomfort: After hemorrhoid surgery, particularly external hemorrhoid excision, patients often report varying levels of pain. This pain can be exacerbated by bowel movements, as the area is sensitive and may be swollen. It is important to understand that while some discomfort is expected, severe pain that does not improve with pain medication should be evaluated by your healthcare provider.

2. Swelling: Swelling around the surgical site is a normal part of the healing process. However, if the swelling is significant or accompanied by severe pain, it may indicate complications such as infection or hematoma formation.

3. Discharge: It is also common to experience some discharge from the surgical site. This can include blood or a foul-smelling fluid, which may be a sign of infection. If the discharge is excessive or has a strong odor, it is crucial to contact your doctor for further evaluation.

4. Bowel Movements: Many patients find that bowel movements are painful in the days following surgery. This can be due to swelling and sensitivity in the area. It is essential to avoid straining during bowel movements, as this can worsen pain and delay healing.


Pain Management Strategies
1. Medications: Over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen can help manage pain. If your doctor has prescribed stronger pain medications, be sure to take them as directed. Always consult your healthcare provider before starting any new medication.

2. Topical Treatments: While there are various over-the-counter creams and ointments available, it is best to consult your doctor before using any topical treatments. Some may contain ingredients that can irritate the area further. Your doctor may recommend a specific ointment that can help soothe the area and promote healing.

3. Sitz Baths: Taking warm sitz baths several times a day can help alleviate pain and promote healing. Soaking the area in warm water can reduce swelling and provide comfort.

4. Dietary Adjustments: To ease bowel movements, consider increasing your fiber intake through fruits, vegetables, and whole grains. Staying hydrated is also crucial, as it helps soften stools and reduces the risk of straining.

5. Avoiding Strain: It is vital to avoid heavy lifting and straining during bowel movements. If necessary, consider using a stool softener to make bowel movements easier.


When to Seek Medical Attention
If you experience any of the following symptoms, it is important to contact your healthcare provider:
- Severe or worsening pain that is not relieved by medication.

- Excessive bleeding or discharge from the surgical site.

- Signs of infection, such as fever, chills, or increased redness and swelling around the incision.

- Difficulty urinating or having bowel movements.


Conclusion
Recovery from hemorrhoid surgery can be uncomfortable, but understanding what to expect and how to manage your symptoms can make the process more manageable. Always keep an open line of communication with your healthcare provider, and do not hesitate to reach out if you have concerns about your recovery. Your health and comfort are paramount, and your doctor can provide the best guidance tailored to your specific situation.

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