Post-Surgery Bleeding Issues: Hemorrhoid Recurrence and Treatment

Postoperative bleeding issues after hemorrhoid surgery?

Hello Doctor, I am the person who asked question #174827.
I would like to ask you again: 1.
I had a colonoscopy in July, and the doctor only mentioned that I had internal and external hemorrhoids.
However, I clearly had minimally invasive surgery for hemorrhoids at the end of February.
Why would I have hemorrhoids again in such a short period? 2.
You mentioned that the rectal bleeding is likely not caused by skin tags, but rather by residual hemorrhoidal tissue.
Is this residual hemorrhoidal tissue what is left untreated from the previous hemorrhoids? Would this require further surgical intervention? Thank you very much.

Niming, 30~39 year old female. Ask Date: 2021/10/26

Dr. Ke Fangxu reply Surgery

1.
Different minimally invasive surgeries can result in varying degrees of residual hemorrhoidal tissue.
Even traditional surgeries may leave some hemorrhoidal tissue intact to maintain normal anal sphincter pressure.
As long as there is no bleeding or pain, it is not a concern.

2.
The normal function of hemorrhoidal tissue is to maintain the closure of gases and liquids.
If it is completely removed, there would indeed be no bleeding, but this would lead to abnormal control of anal contraction.
Hemorrhoidectomy aims to strike a balance between these two aspects.
Sometimes, there may still be slight bleeding post-surgery.
It is recommended to improve your lifestyle, diet, and bowel habits.

Reply Date: 2021/10/26

More Info

Post-surgery bleeding issues, particularly in the context of hemorrhoid surgery, can be quite concerning for patients. Your situation raises important questions about the recurrence of hemorrhoids and the management of any residual tissue that may cause complications.

1. Recurrence of Hemorrhoids: It is indeed possible to experience hemorrhoids again shortly after surgery. Hemorrhoids can recur for several reasons, including the presence of residual hemorrhoidal tissue that was not completely removed during the initial procedure. Factors such as dietary habits, bowel habits, and underlying conditions like chronic constipation or diarrhea can also contribute to the development of new hemorrhoids. In your case, having undergone a minimally invasive procedure in February and then being diagnosed with hemorrhoids again in July suggests that there may have been some residual tissue that was not adequately addressed during the first surgery.

2. Residual Hemorrhoidal Tissue: The term "residual hemorrhoidal tissue" refers to any remaining hemorrhoidal tissue that was not excised during the initial surgery. This tissue can still be susceptible to inflammation and can lead to symptoms such as bleeding, pain, or discomfort. If the residual tissue is causing significant symptoms, it may warrant further surgical intervention. However, the decision to proceed with additional surgery should be made in consultation with your healthcare provider, who can assess the extent of the problem and recommend the best course of action.

3. Management of Post-Surgery Bleeding: If you are experiencing post-surgery bleeding, it is crucial to monitor the situation closely. Minor bleeding can sometimes occur after hemorrhoid surgery, especially if there is straining during bowel movements or if the surgical site is healing. However, if the bleeding is significant or persistent, it is essential to seek medical attention. Your doctor may recommend conservative measures such as dietary changes to increase fiber intake, stool softeners, or topical treatments to alleviate symptoms. In some cases, further surgical intervention may be necessary to address any complications or residual tissue.

4. Preventive Measures: To prevent the recurrence of hemorrhoids, consider adopting lifestyle changes that promote healthy bowel habits. This includes maintaining a high-fiber diet, staying well-hydrated, and avoiding prolonged sitting on the toilet. Regular exercise can also help improve bowel function and reduce the risk of constipation.

5. Follow-Up Care: Regular follow-up appointments with your healthcare provider are essential after any surgical procedure. These visits allow for monitoring of your recovery and the opportunity to address any concerns that may arise. If you notice any new symptoms or changes in your condition, do not hesitate to reach out to your doctor.

In summary, while it is possible to experience hemorrhoids again after surgery, understanding the reasons behind this recurrence and addressing any residual tissue is crucial for effective management. Open communication with your healthcare provider will help ensure that you receive appropriate care and guidance tailored to your specific situation.

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