Managing Post-Surgery Bleeding After Hemorrhoid Surgery: What to Expect

Postoperative bleeding after hemorrhoid surgery?

Hello, Doctor.
I would like to ask: I underwent a minimally invasive surgery for mixed hemorrhoids at the end of February (the surgical note mentioned minimally invasive + biological tissue adhesive?).
Since then, I have been following the doctor's advice to take stool softeners and soak in warm water, and the doctor said my recovery was going well.
However, at the end of March, I experienced bleeding due to hard stools.
Starting in April, I have been experiencing intermittent bleeding during bowel movements, but there is no pain.
The blood on the toilet paper is not bright red; it appears to be a diluted light red, and there is also blood in the stool.
I returned for follow-ups in early April, late April, and early May, and the doctor mentioned that "the wound has split, with a deeper fissure and skin breakdown." They prescribed suppositories and hemostatic medication.
Now, at the end of May, although the frequency of bleeding has decreased compared to April, I am still anxious every time I go to the bathroom, fearing I will see blood.
I would like to know if this situation can only be managed with daily suppositories for self-healing, or if I need to consider another surgery to repair the fissure.
Thank you very much.

Lin, 30~39 year old female. Ask Date: 2021/05/25

Dr. Ke Fangxu reply Surgery

There are many types of minimally invasive surgeries for hemorrhoids, and without specific information about the instruments and methods used, it is difficult to make a judgment.
If there is a phenomenon of wound dehiscence, it is generally managed with oral medications while waiting for the wound to heal.
If the wound continues to bleed without improvement, different surgical techniques will have different corresponding management strategies.
Therefore, you should discuss the follow-up treatment options with the original surgeon.

Reply Date: 2021/05/25

More Info

Managing post-surgery bleeding after hemorrhoid surgery can be a challenging experience, especially when complications such as fissures occur. It’s understandable to feel anxious about the possibility of bleeding during bowel movements, particularly after having undergone a procedure intended to alleviate such issues.
First, it’s important to recognize that some bleeding after hemorrhoid surgery is not uncommon, especially if you experience hard stools. The presence of blood that appears diluted or mixed with stool can indicate that the bleeding is coming from a fissure or a minor irritation rather than from the surgical site itself. However, any persistent bleeding should be taken seriously, and it’s good that you have been following up with your doctor.

In your case, the development of a fissure, which is a small tear in the lining of the anus, can occur due to straining during bowel movements, especially if the stool is hard. This can lead to discomfort and bleeding, even if the original surgery was successful. The fact that you are experiencing less bleeding now is a positive sign, but the anxiety surrounding bowel movements is understandable.

Here are some strategies to manage your situation:
1. Dietary Adjustments: Focus on a high-fiber diet to help soften your stools. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also crucial, as it helps to keep stools soft and easier to pass.

2. Stool Softeners: Continue using stool softeners as prescribed by your doctor. These can help prevent hard stools and reduce the risk of further fissures.

3. Sitz Baths: Regular sitz baths can help soothe the area and promote healing. Soaking in warm water for about 15-20 minutes several times a day, especially after bowel movements, can provide relief.

4. Topical Treatments: If your doctor has prescribed topical medications or suppositories, continue using them as directed. These can help reduce inflammation and promote healing of the fissure.

5. Monitoring Symptoms: Keep a close eye on your symptoms. If you notice an increase in bleeding, severe pain, or any signs of infection (such as fever or increased swelling), contact your healthcare provider immediately.

6. Follow-Up Appointments: Regular follow-ups with your healthcare provider are essential. If the fissure does not heal with conservative management, your doctor may discuss further treatment options, including the possibility of surgical intervention to repair the fissure.

7. Mental Health Considerations: It’s also important to address the anxiety you’re feeling about bowel movements. Consider speaking with a mental health professional if your anxiety becomes overwhelming, as they can provide strategies to help manage your fears.

In conclusion, while it may take time for the fissure to heal, there are several steps you can take to facilitate recovery and manage your symptoms. If conservative measures do not lead to improvement, further evaluation and potential surgical options may be necessary. Always communicate openly with your healthcare provider about your concerns and progress to ensure you receive the best possible care.

Similar Q&A

Post-Surgery Recovery Issues: Managing Pain and Bleeding After Hemorrhoid Surgery

Hello Dr. Ke, I underwent traditional hemorrhoid surgery in June 2015, during which both internal and external hemorrhoids were excised. However, my recovery has not been satisfactory. I have a regular bowel movement once a day, but I notice some blood on the stool, particularl...

Dr. Ke Fangxu reply Surgery
Mild bleeding within one month after hemorrhoid surgery is considered normal. During this period, it is recommended to avoid constipation and to take warm sitz baths frequently. However, if there is heavy bleeding or if the bleeding lasts longer than one month, it is important to...

Post-Surgery Bleeding Concerns After Hemorrhoidectomy: A Week Later

Hello, Doctor. I had a hemorrhoidectomy at Tri-Service General Hospital a week ago. I started having bowel movements on the third day post-surgery, but on the fourth night, after passing gas, I noticed blood staining my outer pants (the stain was about five centimeters in diamete...

Dr. Ke Fangxu reply Surgery
After hemorrhoid excision surgery, it is possible to experience bleeding. Generally, medication can alleviate the bleeding. However, if the bleeding does not stop, a return to the operating room for suturing and hemostasis may be necessary. It is recommended that you return to th...

Managing Post-Surgery Care After Hemorrhoid Surgery: A Patient's Guide

Hello, doctor. I have been experiencing significant bleeding and have had to repeatedly visit the emergency room for re-suturing after my mixed hemorrhoid surgery two weeks ago, despite following all the postoperative care instructions provided. I am unsure how to manage this sit...

Dr. Ke Fangxu reply Surgery
Answer: The likelihood of postoperative bleeding after hemorrhoid surgery is very low and is generally believed to be related to the absorption of sutures. If bleeding occurs and has already been addressed with two suturing procedures, it is unlikely to happen again and should no...

Post-Banding Bleeding After Hemorrhoid Surgery: What to Do?

Hello, over the past week I have experienced bleeding from mixed internal and external hemorrhoids (bright red in the toilet). Yesterday, I underwent a procedure at a nearby major hospital to ligate the internal hemorrhoid and have surgery scheduled for the 14th. This morning, my...

Dr. Zhang Shuhao reply Surgery
After the ligation of internal hemorrhoids, they may undergo ischemia and gradually fall off. The wound after detachment may have a small amount of bleeding, which is normal as long as the amount is not significant, and there is no need for an urgent follow-up. However, if there ...