Post-Surgery Complications: Bleeding and Pain After Hemorrhoid Surgery

Postoperative swelling and bleeding during bowel movements after hemorrhoid surgery?

Hello Doctor: I underwent a mixed hemorrhoidectomy in mid-October, and the surgeon confirmed that the postoperative wound was healing well.
However, one month after the surgery, I experienced difficulty in bowel movements.
After a digital examination by the surgeon, it was confirmed that my stool was impacted, which was causing the blockage.
I was able to have a bowel movement after using an enema, but I still frequently experience irregular bowel movements (despite eating vegetables and drinking water).
There have been several instances where my stool was harder, and I had to strain to pass it, resulting in discomfort around the anus (but no bleeding).
Recently, over the past two weeks, I have noticed that my stool has become harder, and I experience pain when passing it through the anal canal, along with bleeding (on toilet paper and in the toilet bowl).
There are streaks of blood in the stool, and the toilet has drops of blood (similar to menstrual bleeding).
I also noticed some swelling around the anal area.
I am unsure if this is related to the healing of the surgical wound, if the bleeding is due to anal fissures, or if new hemorrhoids have developed.
I am really worried.

Shih, 20~29 year old female. Ask Date: 2022/01/12

Dr. Chen Ronghong reply Surgery

Hello Shih, based on your description, it is possible that the anal canal has become narrower after hemorrhoid surgery.
The cause could be swelling at the surgical site or an actual structural narrowing.
It is advisable to seek medical evaluation to determine if gradual anal dilation is necessary.
If there is still swelling, warm sitz baths can help improve blood circulation.
Before seeing a doctor, increasing fluid intake can help reduce the hardness of stools, which may prevent anal fissures and bleeding.

Reply Date: 2022/01/12

More Info

After undergoing hemorrhoid surgery, it is not uncommon for patients to experience complications such as bleeding, pain, and difficulties with bowel movements. Your concerns about the symptoms you are experiencing—hard stools, pain during bowel movements, and the presence of blood—are valid and warrant careful consideration.

Firstly, it is important to understand that after hemorrhoid surgery, the surgical site can be sensitive and may take time to heal. The presence of blood in your stool or on toilet paper can be alarming, but it can occur for several reasons. One possibility is that you may be experiencing anal fissures, which are small tears in the lining of the anus that can occur due to passing hard stools. These fissures can cause significant pain and bleeding, especially during bowel movements.
Another possibility is that the bleeding could be related to the surgical site itself. If the area has not fully healed, straining during bowel movements can lead to reopening of the surgical site, resulting in bleeding. Additionally, if you have a history of hemorrhoids, it is possible for them to recur, especially if there is increased pressure in the rectal area due to straining or constipation.

To address your symptoms, here are some recommendations:
1. Dietary Adjustments: Ensure that you are consuming a high-fiber diet, which can help soften stools and make bowel movements easier. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated by drinking plenty of water is also crucial.

2. Stool Softeners: Over-the-counter stool softeners can be beneficial in preventing hard stools and reducing straining during bowel movements. Consult your healthcare provider for recommendations on which products may be suitable for you.

3. Sitz Baths: Taking warm sitz baths can help soothe the anal area, reduce discomfort, and promote healing. Soaking in warm water for 15-20 minutes several times a day can be very beneficial.

4. Avoid Straining: It is essential to avoid straining during bowel movements. If you feel the urge to go but are having difficulty, consider using a stool softener or laxative as directed by your physician.

5. Follow-Up with Your Surgeon: Given your symptoms, it is crucial to follow up with your surgeon or healthcare provider. They can perform a thorough examination to determine the cause of your bleeding and discomfort. They may need to assess for any complications such as fissures, recurrent hemorrhoids, or issues related to the surgical site.

6. Pain Management: If you are experiencing significant pain, discuss pain management options with your healthcare provider. They may recommend over-the-counter pain relievers or prescribe medications to help manage your discomfort.

In summary, while some bleeding and discomfort can be expected after hemorrhoid surgery, the presence of hard stools, pain, and significant bleeding should be evaluated by a healthcare professional. It is essential to address these issues promptly to prevent further complications and ensure proper healing. Your health and comfort are paramount, so do not hesitate to seek medical advice regarding your symptoms.

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