Post-Surgery Bowel Issues: Recovery After Hemorrhoid Surgery

Postoperative bowel issues after hemorrhoid surgery?

I would like to explain my situation again.
I had traditional surgery for both internal and external hemorrhoids on May 10.
I am taking stool softeners regularly, but I might not be drinking enough water.
Throughout the process, I have felt the urge to defecate, but when I sit on the toilet, it only results in passing gas, and the urge disappears.
On May 15, I really wanted to have a bowel movement, but I was constipated and couldn't go.
I called the emergency department, and they advised me that if it wasn't urgent, I could wait until my follow-up appointment the next day.
On May 16, during my follow-up, the doctor first removed my stitches and then helped to relieve my constipation.
After that, I was given a prescription for medication and an enema.
However, after waiting for eight minutes with no effect, I went home.
At home, I tried glycerin, but for some reason, I could only administer a small amount.
I attempted it twice, but couldn't inject it completely.
Nevertheless, I managed to expel some stool, and I felt much better afterward.
On May 17, after getting up and having lunch, the urge to defecate returned, similar to the previous day, accompanied by slight abdominal discomfort.
I squatted multiple times but was still clearly constipated.
I tried glycerin again, but this time it was worse; I couldn't inject any at all and had to give up.
On May 18, I made an urgent appointment to see the doctor.
The doctor prescribed me mineral oil.
I returned home around noon, feeling anxious that taking the mineral oil would worsen my abdominal discomfort.
I was worried that if I felt uncomfortable and couldn't defecate, it would be even more distressing.
So, I tried to have a bowel movement again.
While squatting, I rinsed my bottom with warm water and soaked in warm water repeatedly.
Eventually, I managed to dig out a small amount of stool, but it was clay-like—not hard, but not soft either.
I thought I was so close to the exit that there was no reason to let it go back home, so I tried for another ten minutes and planned to ask my family for help.
Just as I mentioned that, it seemed to be scared of being dug out and suddenly came out.
After that, I had a wave of soft stool, and after sitting for a minute, I had another wave of soft stool, while the first one was the hardest.

Afterward, I soaked in warm water, had a meal, and rested in bed.
When I got up, I noticed some fecal fluid around my anus, which was quite obvious due to the different color.
I quickly went to sit in warm water again, and shortly after, I felt the urge to defecate once more.
This time, it was also soft stool.
After rinsing my bottom with warm water and soaking again, I got up and noticed there was fecal fluid in the basin.
I am sharing all this to help the doctor understand my situation better.
I would like to ask if this fecal fluid is normal, how long it might last, and if there is a possibility of developing other symptoms.
I am very concerned about potential complications or long-term effects after this ordeal.

Xiao Zhu, 40~49 year old female. Ask Date: 2022/05/18

Dr. Zhang Shuhao reply Surgery

If there was no constipation prior to surgery, the use of castor oil and laxatives may lead to diarrhea.
Additionally, with an anal wound, the sensations of urgency and the need to hold bowel movements can be affected.
If fecal impaction is cleared and diarrhea begins, the dosage of softening agents should be reduced.
The assessment of any potential incontinence as a complication should wait until the wound has healed for an accurate evaluation.

Reply Date: 2022/05/18

More Info

After undergoing hemorrhoid surgery, it is not uncommon for patients to experience bowel issues, including constipation and difficulty with bowel movements. Your situation, as described, highlights several key aspects of recovery that are important to understand.

Firstly, it’s essential to recognize that surgical intervention for hemorrhoids can lead to temporary changes in bowel habits. The surgery itself can cause swelling and discomfort in the anal area, which may make it difficult to pass stool. Additionally, the use of pain medications, especially opioids, can lead to constipation, which may exacerbate the feeling of needing to have a bowel movement without being able to do so.

In your case, it seems that you are experiencing a combination of constipation and possibly some residual effects from the surgery. The fact that you have been using stool softeners and glycerin suppositories indicates that you are taking steps to manage your bowel health, which is crucial. However, it is also important to ensure that you are adequately hydrated, as insufficient fluid intake can contribute significantly to constipation.

The presence of "糞水" (fecal water) that you mentioned could be a result of several factors. It may indicate that there is some residual stool that is mixed with mucus or water, which can happen when the body is trying to pass stool but is unable to do so effectively. This can be a normal part of the recovery process, especially if you have been experiencing constipation. However, if you notice any significant changes in the color, consistency, or odor of your stool, or if you experience any pain, fever, or other concerning symptoms, it would be prudent to consult your healthcare provider.

As for the duration of these symptoms, it can vary widely among individuals. Some patients may find that their bowel habits normalize within a few weeks post-surgery, while others may take longer. It is essential to continue monitoring your symptoms and to maintain open communication with your healthcare provider. They can provide guidance on dietary changes, hydration, and possibly adjusting medications to help alleviate constipation.

In terms of potential complications, while it is unlikely that you will develop severe issues solely from the symptoms you described, it is always wise to be vigilant. If you experience severe pain, bleeding, or any signs of infection, you should seek medical attention immediately. Additionally, if your bowel issues persist beyond a reasonable timeframe, further evaluation may be necessary to rule out any underlying conditions.

To summarize, while your experiences post-hemorrhoid surgery are not uncommon, it is crucial to stay proactive about your recovery. Ensure you are drinking enough fluids, consider dietary adjustments to include more fiber, and continue using stool softeners as needed. If symptoms persist or worsen, do not hesitate to reach out to your healthcare provider for further evaluation and management. Recovery can take time, but with the right approach, you can expect to see improvement in your bowel function.

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