Post-Surgery Concerns After Laser Hemorrhoidectomy: What to Expect

Postoperative issues after hemorrhoid surgery?

Hello doctor, I had laser surgery for hemorrhoids a few days ago (I'm not sure if that's the correct term, but I know it's not traditional surgery).
Today is the third day post-operation.
At home, I've been experiencing difficulty with bowel movements (I feel the urge but can't pass stool easily, even after taking stool softeners).
I've been soaking in warm water, which has helped a bit, but it's still not smooth, and I don't feel completely empty.
Now, I notice that after bowel movements or soaking my anus, there is some leakage of stool and difficulty cleaning properly.
Could this be due to swelling in the anal area that hasn't resolved yet? Thank you very much.

suney, 40~49 year old female. Ask Date: 2022/02/13

Dr. Zhang Shuhao reply Surgery

After hemorrhoid surgery, you may experience a sensation of needing to have a bowel movement due to tissue swelling, even though the rectum does not actually contain stool.
If you are unable to pass stool, avoid straining.
Instead, you can soak in warm water to reduce swelling and relax the muscles.
After some time, if you still feel the urge, you can try again.
It’s important to stay well-hydrated, and if you typically do not suffer from constipation, avoid overusing stool softeners.
If diarrhea occurs, it can lead to increased discomfort and may not be beneficial for the healing wound, so it’s advisable to pause any stool softeners.
Modern surgical techniques rarely result in anal stenosis, so if your symptoms are gradually improving, there is no need for concern; just follow up with your scheduled appointments.

Reply Date: 2022/02/13

More Info

After undergoing a laser hemorrhoidectomy, it is common to have various concerns and questions regarding the recovery process. Your experience of feeling discomfort and having difficulty with bowel movements is not unusual, especially within the first few days post-surgery. Here’s what you can expect and some insights into your current situation.

Understanding Post-Surgery Symptoms
1. Bowel Movement Difficulties: After a laser hemorrhoidectomy, it’s typical to experience some changes in bowel habits. The surgery can cause swelling and discomfort in the anal area, which may lead to difficulties in passing stool. It’s good to hear that you are taking softening agents, as maintaining soft stools is crucial during recovery. Straining can exacerbate pain and prolong healing.

2. Swelling and Discomfort: The sensation of swelling in the anal area is common after surgery. This swelling can lead to a feeling of fullness or pressure, making it difficult to have a complete bowel movement. It’s important to be patient, as the swelling should gradually subside over the coming days to weeks.

3. Post-Defecation Symptoms: The presence of mucus or a watery discharge after bowel movements can also be a normal part of the healing process. This may occur due to irritation of the anal tissues or residual swelling. As the area heals, this should improve.

Recommendations for Recovery
1. Diet and Hydration: Ensure you are consuming a high-fiber diet to facilitate easier bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is equally important, as it helps soften the stool.

2. Warm Baths: Continue with warm sitz baths, as they can help soothe the area, reduce swelling, and promote healing. Aim for 15-20 minutes several times a day, especially after bowel movements.

3. Avoid Straining: If you feel the urge to go but are having difficulty, try not to strain. Instead, give yourself time and consider using a stool softener or a gentle laxative if necessary, but consult your doctor before starting any new medications.

4. Follow-Up Care: It’s essential to keep your follow-up appointments with your healthcare provider. If you notice any signs of infection (such as increased redness, swelling, or discharge), or if your symptoms worsen, don’t hesitate to reach out to your doctor.

5. Pain Management: If you are experiencing significant pain, discuss pain management options with your healthcare provider. Over-the-counter pain relievers may help, but ensure they are appropriate for your situation.

When to Seek Help
If you continue to experience significant difficulties with bowel movements, persistent pain, or if you notice any unusual symptoms (such as fever or excessive bleeding), it’s crucial to contact your healthcare provider. They can assess your situation and determine if any further intervention is necessary.

Conclusion
In summary, while your symptoms are concerning, they are not uncommon following a laser hemorrhoidectomy. With proper care, attention to diet, and patience, you should see improvement in your symptoms. Always keep an open line of communication with your healthcare provider to ensure a smooth recovery process. Remember, healing takes time, and it’s essential to be gentle with yourself during this period.

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