Recurrence of External Hemorrhoids After Surgery

Post-hemorrhoid surgery

Hello Dr.
Ke, I would like to ask you about my situation.
Three days after undergoing an external hemorrhoid excision in the outpatient clinic, I developed a thrombosed external hemorrhoid at the same location.
I have been taking sitz baths, avoiding straining during bowel movements, and rinsing with warm water postoperatively.
I would like to know if this indicates that the initial treatment was inadequate, or is it possible for a recurrence to happen in such a short time?

Mr. Wang, 30~39 year old female. Ask Date: 2021/08/24

Dr. Ke Fangxu reply Surgery

Outpatient thrombectomy does have a chance of recurrence because it is not a complete hemorrhoidectomy.
If there are still post-operative bowel issues (such as constipation, diarrhea, or prolonged straining during bowel movements), the likelihood of recurrence increases.
In such cases, one can choose to undergo another thrombectomy or use topical ointments to facilitate the absorption of the thrombus.

Reply Date: 2021/08/24

More Info

Understanding the recurrence of external hemorrhoids after surgery can be quite complex, and it is important to consider several factors that may contribute to this situation. After undergoing a surgical procedure for the removal of an external thrombosed hemorrhoid, it is not uncommon for patients to experience some discomfort or complications in the days following the surgery.
Firstly, it is essential to understand that external hemorrhoids can recur even after surgical intervention. The recurrence may be due to several reasons, including the presence of underlying conditions that predispose an individual to develop hemorrhoids, such as chronic constipation, straining during bowel movements, or prolonged sitting. Even after surgery, if these risk factors are not adequately managed, there is a possibility of developing new hemorrhoids or experiencing a recurrence of the existing ones.

In your case, experiencing a recurrence of a thrombosed external hemorrhoid just three days post-surgery raises some concerns. While it is possible for a new thrombosis to develop in the same area, it is also important to consider whether the surgical site has healed properly. Factors such as inadequate post-operative care, including not following the recommended guidelines for bowel movements and hygiene, can contribute to complications.
You mentioned that you have been practicing sitz baths and avoiding straining during bowel movements, which are indeed beneficial practices for promoting healing and comfort. However, if you are still experiencing significant pain, bleeding, or the formation of new blood clots, it may indicate that the initial surgery did not fully address the issue, or that there are other underlying factors at play.

To manage this situation effectively, it is crucial to follow up with your healthcare provider. They may recommend further evaluation to determine the extent of the recurrence and to rule out any complications such as infection or improper healing. In some cases, additional treatments may be necessary, which could include further surgical intervention or non-surgical options such as rubber band ligation or sclerotherapy, depending on the severity of the hemorrhoids.

In addition to medical management, lifestyle modifications can play a significant role in preventing future recurrences. This includes maintaining a high-fiber diet to promote regular bowel movements, staying hydrated, and avoiding prolonged sitting or straining during bowel movements. Regular exercise can also help improve bowel function and reduce the risk of hemorrhoids.

In summary, while it is possible for external hemorrhoids to recur shortly after surgery, it is essential to assess the situation with your healthcare provider. They can provide guidance on the best course of action and help you implement strategies to prevent future occurrences. Remember, effective management of hemorrhoids often requires a combination of medical treatment and lifestyle changes to achieve the best outcomes.

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