Post-Surgery Bowel Issues: Managing Symptoms After Hemorrhoid Surgery

Postoperative bowel issues after hemorrhoid surgery?

I had traditional surgery on May 10th.
I was discharged on the 11th and felt the urge to go to the bathroom.
When I sat down, I passed gas and then had a watery stool, but it wasn't much.
Since then, until today, the 15th, I haven't had a bowel movement.
I currently feel some urge to go, but it's not very strong.
I soak in warm water at least four times a day and spend about 10 minutes sitting on the toilet before soaking, but I only pass gas.
For the first two days, I didn't pay attention to my soft stool intake and only took one capsule in the morning and evening.
On the 14th, I realized I wasn't eating enough, so I switched back to taking two capsules in the morning and evening.
I'm scheduled for a follow-up on the 16th, and I'm concerned about how this might affect my recovery.
I've tried soaking in water to help with bowel movements, but it hasn't worked.
I don't have the sensation of needing to pass something from my rectum, but my body does feel the urge.
I'm wondering if I can use an enema or take laxatives.

Another small issue is that my stitches still feel tight when I touch them.
Are these stitches the type that need to be removed? Also, I've noticed that I'm urinating quite frequently.
Is this normal?
To summarize, I have three questions:
1.
I've been taking softeners since the surgery, but they haven't been effective.
How can I improve this?
2.
Are my stitches absorbable, or do they need to be manually removed?
3.
Is frequent urination normal?
4.
I've noticed a little bit of blood when soaking.
Is this normal?
Thank you for your answers.
This is my first time having this surgery, and I feel a lot of insecurity because I can't ask follow-up questions here, so I have to start a new thread each time.
Thank you.

Xiao Zhu, 40~49 year old female. Ask Date: 2022/05/15

Dr. Zhang Shuhao reply Surgery

1.
It is recommended to follow the original medication frequency prescribed by the doctor, increase fluid intake, and try to exert a little when feeling the urge to have a bowel movement.
Enemas are not advised; if bowel movements are still difficult, the dosage of stool softeners can be increased.
However, if there were no issues with constipation prior to surgery, the difficulty is likely due to anxiety and pain from the surgical site.
If you experience severe pain or discomfort in the lower abdomen, you should return for a follow-up examination, as fecal impaction in the rectum can affect wound healing.

2.
Sutures that are exposed on the skin are less likely to be absorbed; if they do not fall off on their own after a few weeks, the doctor will trim the ends in the outpatient clinic.

3.
Pain at the surgical site can prevent the pelvic muscles from fully relaxing, which may slightly affect urination.

4.
It is normal to see a small amount of blood in the bathwater; if the amount is minimal, it is not a cause for concern.

Reply Date: 2022/05/15

More Info

After undergoing hemorrhoid surgery, it is not uncommon to experience various bowel-related issues as your body adjusts to the changes. Let's address your concerns systematically.

1. Bowel Movements and Constipation: It is quite typical for patients to experience changes in bowel habits following surgery. The fact that you are experiencing soft stools but are unable to pass them could be due to several factors, including post-operative pain, anxiety about bowel movements, or even the effects of anesthesia and pain medications. It is essential to maintain a diet rich in fiber and stay hydrated, as this can help facilitate bowel movements. If you are not experiencing relief, it may be beneficial to consult your physician about the use of stool softeners or mild laxatives. However, it is crucial to avoid over-reliance on laxatives, as they can lead to dependency.

2. Suture Type: Regarding your sutures, if they are absorbable, they should dissolve on their own within a few weeks. If they are non-absorbable, they will need to be removed by your healthcare provider. It is essential to follow up with your surgeon to determine the type of sutures used and whether they require removal. If you feel tightness or discomfort around the sutures, it is advisable to mention this during your next appointment.

3. Frequent Urination: Increased frequency of urination can occur for various reasons, including anxiety, changes in fluid intake, or even the body's response to post-operative medications. If this symptom persists or is accompanied by pain or discomfort, it would be wise to consult your doctor to rule out any urinary tract issues or other underlying conditions.

4. Slight Bleeding During Sitz Baths: Experiencing a small amount of blood during sitz baths can be concerning, but it may not be unusual in the early stages of recovery. However, it is essential to differentiate between minor spotting and significant bleeding. If the bleeding is minimal and not accompanied by pain, it may be a normal part of the healing process. Still, if you notice an increase in bleeding or if it becomes more than just a few drops, you should contact your healthcare provider immediately.

In summary, your post-surgery symptoms are not uncommon, but they warrant careful monitoring. It is crucial to maintain open communication with your healthcare provider, especially if you have concerns about your recovery. They can provide tailored advice based on your specific situation and ensure that your healing process is on track. Remember, recovery can take time, and it is essential to be patient with your body as it heals.

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