Post-Hemorrhoid Surgery: Addressing Bleeding, Pain, and Urgency Issues

Post-hemorrhoid surgery

Hello doctor, I had a hemorrhoid surgery (using a coagulation knife) 15 days ago, and I have two concerns.
First: I notice blood clots in my stool, approximately once every two days.
Second: I am experiencing pain on the left side of my anus; I have completed a seven-day course of antibiotics and am currently taking one tablet of Butrans twice a day.
Third: Is it normal to have frequent urges to defecate?

Xiao Hei, 50~59 year old female. Ask Date: 2021/10/31

Dr. Ke Fangxu reply Surgery

Mild bleeding and pain at the surgical site after surgery is normal; however, if there are still blood clots two weeks later, you should consult your surgeon to check for poor wound healing that may be causing persistent bleeding.
Frequent urges to defecate can be due to irritation of the surgical site.
Generally, discomfort should lessen two weeks post-surgery, and if there is no improvement, it is advisable to see a doctor for further evaluation.

Reply Date: 2021/10/31

More Info

Post-hemorrhoid surgery, especially after procedures like the one you described (using a cold knife technique), can lead to several common issues, including bleeding, pain, and changes in bowel habits. Let's address your concerns one by one.

1. Bleeding with Blood Clots
Experiencing blood in your stool, especially in the form of blood clots, can be concerning. After hemorrhoid surgery, it's not uncommon to see some blood due to the healing process. The surgical site can be sensitive, and as you pass stool, it may irritate the area, leading to minor bleeding. However, if you are seeing blood clots consistently every two days, it’s essential to monitor the situation closely. While some bleeding can be normal, significant or persistent bleeding should be evaluated by your healthcare provider. They may want to perform an examination to ensure that there are no complications, such as a hematoma (a localized collection of blood outside of blood vessels) or infection.

2. Pain on the Left Side of the Anus
Pain in the anal area post-surgery can also be expected as the tissues heal. The pain you are experiencing on the left side could be due to several factors, including inflammation, irritation from bowel movements, or even a possible infection. Since you mentioned that you have completed a course of antibiotics, it’s crucial to follow up with your doctor if the pain persists or worsens. They may need to assess the surgical site for any signs of complications, such as abscess formation or improper healing.

3. Frequent Urgency to Defecate
Feeling a frequent urge to have a bowel movement can be a common experience after hemorrhoid surgery. This sensation may arise from several factors, including changes in bowel habits due to pain or discomfort, anxiety about bowel movements, or even the body's response to the surgical trauma. It’s essential to ensure that you are not straining during bowel movements, as this can exacerbate pain and bleeding. Maintaining a high-fiber diet and staying well-hydrated can help soften stools and make bowel movements easier, potentially reducing urgency and discomfort.

Recommendations for Recovery
- Follow-Up Appointments: Ensure you have scheduled follow-up appointments with your surgeon or healthcare provider. They can assess your healing progress and address any complications.

- Pain Management: Continue to take pain medications as prescribed. If the pain is not adequately controlled, discuss alternative pain management strategies with your doctor.

- Dietary Adjustments: Focus on a high-fiber diet, including fruits, vegetables, and whole grains, to promote regular bowel movements and reduce straining.

- Hydration: Drink plenty of fluids to help keep your stools soft.

- Gentle Care: After bowel movements, consider using a sitz bath or gentle cleansing methods to soothe the area without causing irritation.

- Monitor Symptoms: Keep track of your symptoms, including the frequency and amount of bleeding, pain levels, and any changes in bowel habits. Report any significant changes to your healthcare provider promptly.

In conclusion, while some bleeding, pain, and urgency can be part of the recovery process after hemorrhoid surgery, it is crucial to communicate openly with your healthcare provider about your symptoms. They can provide tailored advice and interventions to ensure a smooth recovery and address any complications that may arise.

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