Post-Surgery Pain and Swelling After Anal Polyp Removal: What to Expect

Severe pain and swelling after anal polyp surgery?

I would like to ask Dr.
Ke: I underwent a PPH (Procedure for Prolapse and Hemorrhoids) surgery in 2021, but I feel that my condition did not fully improve afterward.
Less than a year later, I experienced pain and protrusion from the anal area during bowel movements, which required me to push it back in and was accompanied by slight bleeding.
After multiple follow-up visits, I was diagnosed with an anal polyp and underwent excision.
Currently, it is the fifth day post-surgery, and there is significant swelling at the anal area, resembling a large almond.
Bowel movements are extremely painful, and I can only rely on painkillers.
Due to my multiple drug allergies, neither Tainan Hospital nor Mackay Memorial Hospital prescribed me anti-inflammatory medication.
Both doctors advised me to apply ointment and wait for the swelling to subside, but Mackay mentioned that this could be classified as thrombosed hemorrhoids, which is very painful, yet they only instructed me to apply ointment.
Can my condition truly improve gradually just by applying ointment? Thank you very much for your response.

lala, 30~39 year old female. Ask Date: 2022/02/10

Dr. Ke Fangxu reply Surgery

Common issues associated with PPH (Procedure for Prolapse and Hemorrhoids) circular resection surgery include: first, the resection site being too low, resulting in persistent wound pain; second, suboptimal removal of hemorrhoidal tissue; and third, inadequate management of rectal mucosal prolapse leading to ongoing prolapse after surgery.
I’m not sure in which month your surgery was performed in 2021, but most physicians would generally advise against undergoing another surgical treatment in a short time frame.
Therefore, it is recommended that you first pursue more conservative treatment options.

Reply Date: 2022/02/10

More Info

After undergoing anal polyp removal surgery, it is not uncommon to experience pain and swelling in the surgical area. The symptoms you are describing, such as significant swelling at the anal site, pain during bowel movements, and reliance on pain medication, can be expected in the immediate postoperative period.
Typically, after any surgical procedure involving the anal region, including polyp removal, patients may experience discomfort due to the trauma inflicted during surgery. The swelling you are observing, which resembles a large almond, could be a result of inflammation or even a hematoma (a localized collection of blood outside of blood vessels) that can occur post-surgery. This is particularly common in procedures involving delicate tissues like those around the anus.

The pain you are experiencing, especially during bowel movements, is also a common complaint. The anal area is highly sensitive, and any surgical intervention can lead to increased sensitivity and discomfort as the tissues heal. It is important to note that while pain is a normal part of the healing process, it should gradually decrease over time. If the pain persists or worsens, or if you notice any signs of infection (such as increased redness, warmth, or discharge), it is crucial to seek medical attention.

Regarding the management of your symptoms, your doctors have recommended topical treatments, which can be effective in reducing inflammation and promoting healing. Applying a topical ointment as prescribed can help soothe the area and may assist in reducing swelling. Additionally, warm sitz baths can provide relief and help with the healing process. These baths can help relax the anal muscles and promote blood flow to the area, which may alleviate some discomfort.

It is also essential to maintain a diet that promotes soft stools to minimize straining during bowel movements. Incorporating fiber-rich foods, staying hydrated, and possibly using a stool softener can help ease the passage of stool and reduce pain during bowel movements.

If your symptoms do not improve or if you continue to experience significant pain, it may be necessary to revisit your healthcare provider for further evaluation. They may consider additional treatments or interventions, especially if there is a concern about complications such as thrombosed hemorrhoids, which can occur after anal surgery.

In summary, while some pain and swelling are normal after anal polyp removal, it is essential to monitor your symptoms closely. Follow your doctor's advice regarding topical treatments and dietary adjustments, and do not hesitate to seek further medical evaluation if your condition does not improve. Healing takes time, and with proper care, you should see gradual improvement in your symptoms.

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