Post-Hemorrhoid Surgery: Managing Anal Stenosis and Treatment Options

Postoperative care for hemorrhoids?

Hello Dr.
Ke: I underwent hemorrhoid surgery on June 30, and postoperatively developed anal stenosis due to scar tissue formation.
I started self-dilation in early September, performing it twice daily for about five minutes each session.
After two months, I stopped because there was no pain, but it recurred three weeks later.
I would like to ask: 1.
Should I continue the dilation? (Currently, I am still doing it twice daily.) 2.
Is it correct to only use my middle finger for the massage? 3.
Aside from surgery, are there any other treatment options available? Thank you for your response.

Xiao Chen, 40~49 year old female. Ask Date: 2021/12/08

Dr. Ke Fangxu reply Surgery

1.
If the issue of pain during defecation caused by anal stenosis is not resolved, then anal dilation should continue.
2.
If possible, gradually increase the number of fingers inserted.
3.
There is no option but to proceed slowly with the anal dilation treatment.

Reply Date: 2021/12/08

More Info

Post-hemorrhoid surgery complications, such as anal stenosis, can be quite challenging for patients. Anal stenosis, or narrowing of the anal canal, can occur due to scar tissue formation following surgery. This condition can lead to discomfort, difficulty with bowel movements, and other complications. Here’s a comprehensive overview of managing anal stenosis after hemorrhoid surgery, including treatment options and recommendations based on your questions.

1. Should you continue anal dilation?
Yes, continuing anal dilation can be beneficial in managing anal stenosis. Regular dilation helps to stretch the scar tissue and can improve the width of the anal canal over time. It is important to perform this gently to avoid causing additional trauma or discomfort. If you have been doing this twice a day and have seen some improvement, it may be worthwhile to continue this regimen. However, if you experience significant pain or bleeding, it is advisable to consult your healthcare provider.

2. Is using your index finger for massage appropriate?
Using your index finger for gentle massage and dilation can be an effective method for managing anal stenosis. However, it is crucial to ensure that your hands are clean and that you are using a lubricant to minimize discomfort. The goal is to gradually stretch the anal canal without causing pain. If you feel that this method is not providing relief or if you are experiencing pain, consider discussing alternative methods with your doctor.

3. Are there other non-surgical treatment options?
Besides manual dilation, there are several non-surgical treatment options for anal stenosis:
- Topical Treatments: Your doctor may recommend topical medications, such as corticosteroids, to reduce inflammation and promote healing of the anal tissue.

- Anal Dilators: There are commercially available anal dilators that can provide a more consistent and controlled method of dilation compared to manual methods.

- Biofeedback Therapy: This therapy can help you learn to relax the anal sphincter muscles, which may alleviate some of the symptoms associated with anal stenosis.

- Dietary Changes: Increasing fiber intake and ensuring adequate hydration can help ease bowel movements, reducing the strain on the anal canal and potentially minimizing discomfort.

- Physical Therapy: Some patients benefit from pelvic floor physical therapy, which can help improve muscle function and coordination in the pelvic area.

4. When to consider surgical options?
If non-surgical methods do not provide relief and your symptoms persist or worsen, it may be necessary to consider surgical options. Surgical interventions can include procedures to remove scar tissue or to widen the anal canal. Discussing the risks and benefits of these options with a colorectal surgeon is essential.

In conclusion, managing anal stenosis after hemorrhoid surgery requires a multifaceted approach. Continuing with anal dilation, using appropriate techniques, and exploring non-surgical treatment options can help alleviate symptoms. Regular follow-up with your healthcare provider is crucial to monitor your condition and adjust treatment as necessary. If you experience any new or worsening symptoms, do not hesitate to seek medical advice. Your comfort and quality of life are paramount, and there are various strategies available to help manage this condition effectively.

Similar Q&A

Post-Surgery Anal Stenosis: Coping with Narrowing After Hemorrhoid Surgery

Hello, doctor. I underwent hemorrhoid surgery using a LigaSure tissue coagulation device, and it has been almost two months since the procedure. The surgeon believes that the narrowing of my anus post-surgery is normal and has told me that this is how it will be. However, I force...

Dr. Ke Fangxu reply Surgery
There are often inquiries on this platform regarding difficulties in bowel movements following surgery with a tissue coagulation device. Currently, there is no long-term statistical data on the use of this device for hemorrhoidectomy, making it difficult to determine if true sten...

Post-Surgery Concerns: Understanding Changes After Hemorrhoid Surgery

Hello: In early December of 1999, I underwent surgery for rectal bleeding accompanied by prolapse (fourth-degree hemorrhoids). After the surgery, my bowel movements became thin and difficult to pass. Although the doctor attempted treatment using digital dilation, there has been l...

Dr. Wang Qichao reply Surgery
Some patients who undergo radical surgery for hemorrhoids may experience anal stenosis. Initially, this can be managed with anal dilation combined with stool softeners. If the stenosis is severe and dilation does not provide relief, partial incision of the internal sphincter or t...

Is Surgery Necessary for Anal Stenosis After Hemorrhoid Surgery?

Hello, Dr. Ke: It has been 10 years since my hemorrhoid surgery, and recently I have been experiencing severe pain in the anal area after bowel movements. Although applying ointments and using suppositories provide some relief, I experience intense pain again the next day after d...

Dr. Ke Fangxu reply Surgery
Hello Qianqian: It is indeed possible to experience anal stenosis after hemorrhoid surgery, but this typically occurs shortly after the procedure. I have not heard of anal stenosis developing ten years post-surgery. Could it be due to anal fissures or a recurrence of hemorrhoids?...

Understanding Anal Stenosis After Hemorrhoid Surgery: Key Insights

Hello Dr. Ke, I have read through your responses multiple times, but I still feel anxious. On January 7th of this year, I underwent a minimally invasive complete excision of hemorrhoids at Far Eastern Memorial Hospital. However, at that time, I was unaware that minimally invasiv...

Dr. Ke Fangxu reply Surgery
1. Anal stenosis is not always a complete or absolute condition; it can vary in severity. While a digital rectal examination can help determine the presence of stenosis, there are different degrees of narrowing. It is generally accepted that if the examination causes pain, it ind...