Traditional hemorrhoid surgery
After undergoing surgery for mixed internal and external hemorrhoids, I went to the hospital for wound checks and dressing changes during the second, third, and fourth weeks.
Each time, it was extremely painful due to tearing.
Starting from the fifth week, I can insert three fingers into the anus, but I encounter a tight ring at the third joint, preventing further insertion.
I can only use one finger at a time.
Is this normal? My bowel movements are consistently thin and elongated.
Sometimes, I can pass stool smoothly, but other times, I have to exert a lot of effort to expel small, segmented stools.
Should I be concerned that this indicates a small anal opening? Additionally, what is the definition of anal dilation? When is it necessary to perform anal dilation? Will the tight ring eventually return to normal, allowing for regular bowel movements like those of an average person?
Awei, 30~39 year old female. Ask Date: 2021/11/18
Dr. Zhang Shuhao reply Surgery
Complete excision of internal and external hemorrhoids typically requires about 4 to 6 weeks for wound healing.
During this period, swelling and pain during bowel movements are considered normal.
Once the wound scabs over, there may be slight loss of elasticity due to fibrosis, but significant anal stenosis affecting bowel function is rare.
As long as bowel movements are normal, there is no need for anal dilation, and you can continue to monitor the situation for a while.
However, if you experience any discomfort, it is advisable to return for a follow-up examination.
Wishing you a speedy recovery.
Reply Date: 2021/11/18
More Info
After undergoing surgery for hemorrhoids, it is common to experience a range of symptoms and discomfort during the recovery process. The pain you are experiencing, especially during the first few weeks post-surgery, is not unusual. Hemorrhoid surgery can involve significant trauma to the tissues in and around the anal area, leading to pain, swelling, and changes in bowel habits.
Understanding Post-Surgery Pain and Recovery
1. Pain Management: It is important to manage pain effectively during recovery. This can include the use of prescribed pain medications, over-the-counter pain relievers, and non-pharmacological methods such as warm sitz baths, which can help soothe the area. If the pain is severe or worsening, it is crucial to consult your healthcare provider for further evaluation.
2. Bowel Changes: The changes you are experiencing in your bowel movements, such as the shape and consistency of your stool, can be attributed to several factors. After surgery, it is common for stool to be thinner or more elongated due to the healing process and potential changes in the anal canal. Straining during bowel movements can also lead to discomfort and should be avoided. A diet high in fiber, adequate hydration, and possibly stool softeners can help facilitate smoother bowel movements.
3. Anal Canal and Recovery: The fact that you can only insert one finger into the anal canal and feel a restriction is something to discuss with your doctor. Post-surgery, the anal canal may be swollen or healing, which can create a temporary narrowing. This condition may improve over time as the tissues heal. However, if you continue to experience significant restrictions or pain, further evaluation may be necessary.
4. Definition of Anal Dilation: Anal dilation refers to the process of gradually stretching the anal canal to alleviate tightness or discomfort. This may be recommended if there is significant narrowing that affects bowel movements. Dilation can be performed using specialized tools or through manual techniques, but it should only be done under the guidance of a healthcare professional.
5. Long-term Expectations: It is difficult to predict exactly how your anal canal will heal and whether it will return to its pre-surgery state. Many patients find that their bowel habits normalize over time, but some may experience ongoing changes. Regular follow-up with your surgeon or a gastroenterologist can help monitor your recovery and address any concerns.
6. When to Seek Help: If you experience severe pain, bleeding, or any signs of infection (such as fever or increased swelling), it is essential to seek medical attention promptly. Additionally, if your bowel habits do not improve or if you have persistent difficulty with bowel movements, further assessment may be necessary.
Conclusion
In summary, your experiences post-hemorrhoid surgery are not uncommon, and many patients go through similar challenges during their recovery. It is crucial to maintain open communication with your healthcare provider, adhere to recommended pain management strategies, and make dietary adjustments to support healthy bowel movements. As your body heals, many of the symptoms you are experiencing may improve, but ongoing monitoring and support will be key to your recovery. If you have any concerns about your healing process or bowel function, do not hesitate to reach out to your healthcare provider for guidance.
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