Post-Hemorrhoid Surgery Pain: Is It Anal Fissure?

Q: Post-Hemorrhoid Surgery Pain: Is It Anal Fissure?

Hello： To stop bleeding, it is important to consume more fruits and vegetables. <br>Stool softeners are recommended. <br>The Changhua Hospital, Ministry of Health and Welfare, cares about you.

Post-hemorrhoidectomy pain suspected to be anal fissure?

Hello, doctor.
Five days ago, I underwent traditional surgery for hemorrhoids.
After the anesthesia wore off, the pain was unbearable.
I received two doses of painkillers, but they did not alleviate the pain.
The doctor mentioned that I had three areas operated on, which resulted in larger wounds and more pain.
I would like to know which three areas those are.
The next day, I was discharged and noticed I started to have a fever around 37.7°C and was sweating profusely.
At home, I just took pain medication and slept, waking up in pain to do sitz baths.
On the third day, I finally had a bowel movement, but the pain was comparable to giving birth.
It felt like the wounds were being forcefully stretched open, and there was bleeding, which was extremely painful.
I almost fainted, but after taking pain medication and applying ointment, I felt somewhat better after about 3 to 4 hours.
However, every subsequent bowel movement felt like giving birth again, with sharp pain as if the wounds were tearing open.
After each bowel movement, I experienced intense heat and pain, and I used a handheld shower to rinse and took warm sitz baths.
I quickly took more pain medication.
I would like to ask the hospital if I should avoid eating and not have bowel movements for now? Would it be better to wait for 3.5 days until the wounds heal before eating and having bowel movements? The pain is truly unbearable...
Please help me, doctor.

Kk, 30~39 year old female. Ask Date: 2021/05/02

Dr. Yu Mingchang reply Surgery

Hello: To stop bleeding, it is important to consume more fruits and vegetables.
Stool softeners are recommended.
The Changhua Hospital, Ministry of Health and Welfare, cares about you.

Reply Date: 2021/05/02

More Info

Post-hemorrhoid surgery pain can be a significant concern for many patients, and your experience reflects some common challenges faced after such procedures. It’s important to understand that the pain you are experiencing may not only be due to the surgical site but could also involve complications such as anal fissures or other issues related to the healing process.

Firstly, after hemorrhoid surgery, especially traditional methods that involve excision, it is common to experience considerable pain. This is due to the nature of the surgery, which often involves cutting through sensitive tissue in the anal area. The three areas your doctor referred to likely include the internal hemorrhoids, external hemorrhoids, and possibly the surrounding tissue that was affected during the procedure. The larger the surgical area, the more pain you may experience post-operatively.

The fever and cold sweats you experienced could indicate an infection, which is a potential complication after any surgical procedure. It’s crucial to monitor your temperature and any other symptoms such as increased redness, swelling, or discharge from the surgical site. If these symptoms persist or worsen, it is essential to contact your healthcare provider immediately.

Regarding your bowel movements, the pain you describe during defecation is not uncommon. After surgery, the anal sphincter can be sensitive, and the act of passing stool can cause significant discomfort, especially if the stool is hard or if there is straining involved. The sensation of the wound feeling like it is "tearing" or "opening" can be alarming and is often associated with anal fissures, which are small tears in the lining of the anus that can occur due to trauma or excessive stretching.

To alleviate your pain and promote healing, consider the following recommendations:
1. Dietary Adjustments: Focus on a high-fiber diet to soften your stools. Include plenty of fruits, vegetables, and whole grains. Staying hydrated is also crucial, as it helps prevent constipation.

2. Stool Softeners: Over-the-counter stool softeners can be beneficial in making bowel movements easier and less painful.

3. Sitz Baths: Continue with warm sitz baths, as they can help soothe the area and promote blood flow, which aids in healing.

4. Pain Management: Continue taking prescribed pain medications as directed. If the pain is not manageable, consult your doctor about adjusting your pain management plan.

5. Avoid Straining: Do not hold off on bowel movements for extended periods. If you feel the urge, try to go to the bathroom, but do so gently. Straining can exacerbate pain and lead to complications.

6. Follow-Up Care: It is essential to have regular follow-ups with your surgeon or healthcare provider to monitor your healing process. If you suspect an anal fissure or if the pain persists, they may recommend treatments such as topical anesthetics or even further interventions.

In conclusion, while the pain you are experiencing is likely a normal part of the healing process after hemorrhoid surgery, it is vital to remain vigilant for signs of complications. Do not hesitate to reach out to your healthcare provider for guidance tailored to your specific situation. They can provide the best advice on managing your pain and ensuring a smooth recovery. Remember, healing takes time, and with the right care, you should start to feel better soon.

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