Post-Surgery Bowel Urgency: Your Symptoms After Hemorrhoid Surgery

Persistent urge to defecate after hemorrhoid surgery?

Hello Dr.
Ke,
I underwent surgery for anal fissure and hemorrhoid excision on February 1st of this year.
Initially, my bowel movements were normal, and I had stopped taking stool softeners.
However, since early March, I have been experiencing a persistent feeling of urgency to have a bowel movement throughout the day.
After I do have a bowel movement, I often feel as though I haven't completely emptied my bowels, and I sometimes feel as if stool is stuck at the anal opening.
My abdomen also feels uncomfortable, and occasionally I hear gurgling sounds, but I often find it difficult to pass more stool even when I feel the urge.
I had a colonoscopy a year and a half ago, which was normal.
Do you think I need to undergo another examination? What could be causing this persistent sensation of urgency?
Additionally, it has been seven weeks since my surgery, and during my follow-up appointment, the doctor mentioned that the wound is healing well.
However, I still occasionally feel discomfort, especially when sitting, walking, or straining slightly during urination, which can cause some pain.
I also experience a sharp pain when passing formed stool.
Is it normal to still have these symptoms so long after surgery? Furthermore, I still feel a strong urgency to have a bowel movement and find it hard to hold it in.
Is this considered normal? I feel like my recovery is progressing much slower than expected, and I am a bit worried and discouraged.
Thank you, Dr.
Ke, for taking the time to respond.
I appreciate your help!

Niming, 30~39 year old female. Ask Date: 2021/03/20

Dr. Ke Fangxu reply Surgery

At the age of 36, it may not be necessary to undergo a colonoscopy so frequently.
The persistent urge to defecate could also be caused by irritation from surgical scars.
If the wound has healed, topical ointments or suppositories can be used to alleviate discomfort.
Taking warm sitz baths may also be beneficial.
If symptoms do not improve over time, it is advisable to consult the surgeon for further evaluation.
A small number of patients may experience infections or the development of fistulas post-surgery, leading to uncomfortable symptoms.

Reply Date: 2021/03/20

More Info

After undergoing hemorrhoid surgery, it is not uncommon for patients to experience a range of symptoms, including bowel urgency and discomfort. Your concerns about persistent feelings of urgency, incomplete evacuation, and discomfort during bowel movements are valid and warrant further discussion.

Firstly, the sensation of having a constant urge to defecate, along with the feeling of incomplete evacuation, can be attributed to several factors post-surgery. One possibility is that the surgical site is still healing, which can lead to heightened sensitivity in the anal region. This sensitivity may cause you to feel as though you need to have a bowel movement even when your bowels are empty. Additionally, the surgical alteration of the anal and rectal anatomy can temporarily disrupt normal bowel function, leading to sensations of urgency or discomfort.

Another factor to consider is the potential for changes in bowel habits following surgery. The removal of hemorrhoids and any associated tissue can alter the way your body processes and expels stool. This can result in a feeling of urgency or the sensation of stool being "stuck" in the rectum. It is also important to note that psychological factors, such as anxiety about bowel movements after surgery, can exacerbate these sensations.

Regarding your physical discomfort, it is not unusual to experience some pain or discomfort in the weeks following surgery, especially when sitting, walking, or during bowel movements. The fact that you are still experiencing pain seven weeks post-surgery may indicate that your body is still in the healing process. However, if the pain is sharp or worsening, or if you notice any unusual symptoms such as bleeding or significant changes in bowel habits, it is crucial to consult your surgeon or healthcare provider for a thorough evaluation.

As for your question about whether you need another examination, it may be beneficial to schedule a follow-up appointment with your healthcare provider. They can assess your symptoms and determine if further diagnostic tests, such as a colonoscopy or imaging studies, are necessary to rule out any complications or underlying issues that may be contributing to your symptoms.

In the meantime, there are several strategies you can employ to help manage your symptoms. Maintaining a high-fiber diet, staying well-hydrated, and practicing good bowel habits can aid in promoting regular bowel movements and reducing the sensation of urgency. If you continue to experience discomfort, your doctor may recommend pain management strategies or medications to help alleviate your symptoms.

Lastly, it is essential to remember that recovery from surgery can vary significantly from person to person. While it is natural to feel concerned about your recovery pace, it is important to be patient with your body as it heals. Open communication with your healthcare provider about your symptoms and concerns will help ensure that you receive the appropriate care and support during your recovery process.

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