Post-hemorrhoid surgery
Hello, doctor.
I underwent a mixed excision surgery for internal and external hemorrhoids last August, and it's been nearly a year since then.
I have two questions I would like to ask:
1.
After using the restroom, I feel that my anus itches or feels damp after a while, especially noticeable during the summer due to increased sweating.
Even after wiping thoroughly, I still find remnants of stool when I return to the restroom later.
Although I clean myself well immediately after a bowel movement, this issue persists.
How can I resolve this?
2.
I often notice blood when using the restroom, but it's not much—usually 1-2 drops, and I don't feel any discomfort.
Is this due to the slow healing of the hemorrhoid wounds? If my stool is slightly hard, the bleeding can be up to 2-3 drops, while with normal consistency, sometimes there is no blood, and other times, I only see blood on the toilet paper when wiping.
The blood is usually bright red.
Additionally, if I use the restroom twice in one day, I always experience bleeding during the second visit, but it’s only a few drops.
Is this normal? Thank you for your answers, doctor.
Luo Xiansheng, 20~29 year old female. Ask Date: 2021/07/26
Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello, a 26-year-old male has undergone hemorrhoid surgery a year ago.
There is residual stool, and it is recommended to increase the intake of fruits and vegetables for fiber, along with adequate hydration and physical activity to help form and pass stool more easily.
The presence of blood in the stool, although minimal, is abnormal.
Common causes include inflammation, hemorrhoids, anal fissures, polyps, and tumors.
It is advised to follow up with a colorectal surgeon or a gastroenterologist.
Wishing you safety and health! Dr.
Lin Ming-Hui, Attending Physician, Department of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.
Reply Date: 2021/07/26
More Info
Post-hemorrhoid surgery, particularly after a mixed internal and external hemorrhoidectomy, can lead to several complications and symptoms that require careful management. Your concerns about itching, bleeding, and hygiene are common among patients recovering from this type of surgery. Let's address each of your questions in detail.
1. Itching and Moisture After Bowel Movements
Itching around the anal area can be attributed to several factors, including moisture, irritation, and even remnants of stool that may not have been completely cleaned away. Here are some strategies to manage this issue:
- Hygiene Practices: After using the toilet, ensure thorough cleaning. Consider using moist wipes or a bidet, which can be gentler and more effective than toilet paper alone. Avoid wipes that contain alcohol or fragrances, as these can irritate the skin.
- Drying Techniques: After cleaning, gently pat the area dry with a soft towel or toilet paper. Avoid rubbing, as this can cause irritation. You might also consider using a hair dryer on a low setting to ensure the area is completely dry, especially in hot weather when sweating can exacerbate moisture issues.
- Barrier Creams: Applying a barrier cream or ointment (like zinc oxide or petroleum jelly) can help protect the skin from moisture and irritation. This can be particularly helpful if you are sweating more in the summer months.
- Clothing Choices: Wear breathable, loose-fitting underwear made of natural fibers to help keep the area dry and reduce irritation.
2. Bleeding After Bowel Movements
Seeing blood after a bowel movement can be concerning, but it is not uncommon after hemorrhoid surgery. Here are some considerations:
- Normal Healing Process: After surgery, it is expected that the surgical site may take time to heal. Minor bleeding, especially if it is bright red, can occur as the tissues heal. However, if the bleeding is persistent or increases in volume, it is important to consult your healthcare provider.
- Stool Consistency: Hard stools can exacerbate bleeding. To prevent this, ensure you are consuming a high-fiber diet, staying hydrated, and possibly using a stool softener if recommended by your doctor. Aim for a diet rich in fruits, vegetables, and whole grains.
- Monitoring Symptoms: If you notice that bleeding occurs consistently, especially after every bowel movement, or if you experience pain, it is crucial to reach out to your healthcare provider. They may want to evaluate the surgical site to ensure there are no complications, such as a fissure or infection.
Additional Considerations
- Follow-Up Appointments: Regular follow-ups with your surgeon or healthcare provider are essential to monitor your healing process. They can provide personalized advice based on your recovery progress.
- Avoid Straining: Straining during bowel movements can lead to increased pressure in the anal area, which can exacerbate bleeding and discomfort. If you find yourself straining, consider discussing this with your doctor, as they may have additional recommendations.
- Signs of Complications: Be vigilant for signs of complications, such as increased pain, swelling, or discharge from the surgical site, as these may indicate an infection or other issues that need to be addressed.
In conclusion, while some itching and minor bleeding can be normal after hemorrhoid surgery, it is essential to maintain good hygiene, monitor your symptoms, and consult with your healthcare provider if you have any concerns. They can provide tailored advice and interventions to ensure a smooth recovery process.
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