Post-Surgery Anal Pain: When to See a Specialist

Anal issues

Hello Doctor, I underwent electrosurgery for a papilloma near the anus on February 8, which included excision.
Two weeks post-surgery, I experienced hard stools that felt like they were cutting me.
I returned to my gynecologist, who prescribed an ointment and advised me to keep the area clean and apply the ointment daily.
This provided some relief and reduced the pain.
During my follow-up two weeks later, the doctor confirmed that the wound near the anus had healed.
However, recently I have been experiencing occasional dull pain around the anus.
When my stools are harder, there is bleeding during bowel movements.
After using the restroom, I notice a yellow discharge from my anus, which is odorless.
I have observed that softer stools result in less pain during bowel movements.
Should I see a colorectal surgeon? Could this be an anal fistula or hemorrhoids?

Liao Xiaojie, 20~29 year old female. Ask Date: 2021/04/02

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like the typical symptoms of an anal fissure, which include pain during bowel movements accompanied by slight bleeding.
The common causes are often constipation or diarrhea.
The fundamental treatment is to improve bowel habits, along with warm sitz baths.
Warm sitz baths can help alleviate pain, maintain cleanliness, and promote blood circulation.
You can also purchase over-the-counter hemorrhoid suppositories for use.
If symptoms persist without improvement, it is advisable to consult a physician for evaluation.

Reply Date: 2021/04/02

More Info

After undergoing surgery for a condyloma acuminatum near the anus, it is not uncommon to experience some discomfort and pain during bowel movements, especially if the stools are hard. Your description of the pain feeling like a knife cutting and the presence of blood during bowel movements suggests that there may be some irritation or trauma to the surgical site, particularly if the stools are not well-formed.
The fact that you have experienced relief with the application of ointment and that your doctor has confirmed the wound is healing is a positive sign. However, the ongoing pain, especially when having hard stools, and the occurrence of yellow discharge after bowel movements warrant further investigation.
Here are some considerations regarding your symptoms:
1. Anal Fissures: The sharp pain during bowel movements could indicate the presence of an anal fissure, which is a small tear in the lining of the anus. This can occur after surgery, particularly if hard stools are involved. Fissures can cause significant pain and bleeding, especially during and after bowel movements.

2. Hemorrhoids: Given your symptoms, it is also possible that you may be experiencing hemorrhoids, which can be exacerbated by straining during bowel movements. Hemorrhoids can cause pain, bleeding, and sometimes a sensation of fullness or discomfort in the anal area.

3. Infection or Abscess: The presence of yellow discharge could suggest an infection or the formation of an abscess. While you mentioned that the discharge is odorless, any unusual discharge following surgery should be evaluated to rule out infection.

4. Scar Tissue or Stricture: Post-surgical changes can lead to scar tissue formation, which may cause narrowing (stricture) of the anal canal, leading to pain during bowel movements.

Given these considerations, it would be prudent to consult a colorectal surgeon (proctologist) for a thorough evaluation. They can perform a physical examination, possibly including an anoscopy, to assess the surgical site and determine the cause of your ongoing symptoms.
In the meantime, to alleviate your symptoms, consider the following:
- Dietary Changes: Increase your fiber intake to help soften your stools. Foods rich in fiber, such as fruits, vegetables, and whole grains, can help prevent constipation and reduce straining during bowel movements.

- Hydration: Ensure you are drinking plenty of water throughout the day, as proper hydration can also help keep stools soft.

- Stool Softeners: Over-the-counter stool softeners can be beneficial in preventing hard stools and reducing pain during bowel movements.

- Warm Sitz Baths: Taking warm baths can help soothe the anal area and promote relaxation, which may alleviate some discomfort.

- Topical Treatments: Continue using any prescribed ointments or creams as directed by your physician to promote healing and reduce pain.

In summary, while some discomfort after surgery is expected, the persistence of pain, bleeding, and discharge should be evaluated by a specialist. Early intervention can help address any complications and improve your quality of life.

Similar Q&A

Understanding Post-Surgery Anal Pain: When to Seek Medical Attention

I had my last hemorrhoid ligation surgery on June 1st. The first day was quite uncomfortable, but afterward, everything was normal. On June 13th, I started feeling intermittent mild pain in my anal area. It's very slight and not extremely painful. Could this be related to th...

Dr. Ke Fangxu reply Surgery
If the hemorrhoid ligation is performed at a shallow depth, there may be a possibility of experiencing pain. If the pain is mild, it is expected to resolve within 1-2 weeks. However, if the pain persists without improvement, a follow-up examination by a physician is necessary.

Understanding Pain After Anal Surgery: What to Expect and Manage

Hello, Doctor: Recently, I sought medical attention for an anal condition, and the doctor informed me that surgery is necessary. I would like to ask, how long does the pain typically last after anal surgery? (I am quite afraid of pain.) Additionally, I have heard that anal surger...

Dr. Hou Yongji reply Surgery
Hello: Anal surgery is indeed a very painful procedure, but if the condition requires it, one should still undergo the surgery. Do not believe the claims from unlicensed practitioners that it won't hurt. To be honest, anal surgery will be painful, but the typical pain should...

Post-Surgery Anal Pain: Understanding Recovery After Hemorrhoid Surgery

Doctor, I apologize for the interruption; my statement is quite complex. I underwent minimally invasive surgery at the clinic on December 27, 2023. The next morning, I experienced tearing pain while having a bowel movement, and upon examination, I discovered a lump outside my anu...

Dr. Zhang Shuhao reply Surgery
Most minimally invasive surgeries available in the market primarily address internal hemorrhoids, but postoperative venous return obstruction can lead to swelling of external hemorrhoids. Taking warm sitz baths and using anti-inflammatory medications can help alleviate symptoms. ...

Chronic Anal Fissure: When to Seek Surgery and What to Expect

Hello, Doctor. I would like to ask about my issue with anal pain during bowel movements. I have been diagnosed with chronic anal fissure. It has been four days since the examination, and I have a habit of using the restroom in the morning and evening, but I still experience pain ...

Dr. Ke Fangxu reply Surgery
Treatment for anal fissures can be quite troublesome, as the healing process is slow, yet it may not be severe enough to warrant surgery. However, if the pain is intense or significantly affects daily life, surgery may be necessary to resolve the issue. Personally, I have not hea...