Post-Surgery Bleeding After Hemorrhoid Surgery: What to Expect

Postoperative bleeding issues after hemorrhoid surgery?

Traditional surgery for both internal and external hemorrhoids was performed on May 10.
I have been taking stool softeners regularly, but I might not be drinking enough water.
During the recovery process, I often feel the urge to defecate, but when I try to use the toilet, it only results in passing gas, and the urge disappears.
On May 15, I had a strong desire to have a bowel movement, but I was constipated and unable to do so.
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 visit, the doctor 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 results, I went home.
At home, I tried using glycerin, but for some reason, I could only administer a small amount.
After two attempts with incomplete administration, I managed to expel some stool, which provided relief.
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 tried several times to use the toilet but was still clearly constipated.
I attempted glycerin again, but this time I couldn't administer any at all and had to give up.
On May 18, I made an emergency appointment to consult with the doctor.
The doctor prescribed mineral oil.
I returned home around noon, feeling anxious that taking the mineral oil would worsen my abdominal discomfort.
Fearing that I wouldn't be able to relieve myself, I decided to try to have a bowel movement again.
While squatting, I used warm water to rinse my bottom and soaked in warm water multiple times.
Eventually, I managed to dig out a small amount of stool, which was clay-like—not hard, but not soft either.
I thought I was close to success, so I tried for another ten minutes and considered asking a family member for help.
Just as I mentioned this, the stool seemed to come out on its own, followed by softer stools.
After sitting for another minute, I had another wave of soft stools, while the first one was the hardest.
I then soaked in warm water, had a meal, and rested in bed.
When I got up, I noticed some fecal water around my bottom, which was evident due to the color difference.
I quickly sat in warm water again and felt the urge to defecate once more, resulting in another soft stool.
After rinsing my bottom with warm water and soaking again, I noticed fecal water in the basin.
On May 23, during my follow-up visit, the doctor removed the remaining stitches and prescribed two stool softeners to be taken twice daily.
Everything seemed normal.
However, on May 28, I noticed blood during my first bowel movement, which made the toilet appear red.
Since I had been rinsing my bottom with warm water, I wasn't sure how much blood there was, but it stopped after the bowel movement.

On May 29, after going out for a haircut, I returned home to find my bottom feeling wet and discovered that I was bleeding.
It didn't seem like a lot, but subsequent bowel movements have also resulted in bleeding, even when passing gas, which has caused a few drops of blood.
I would like to ask the doctor if this is normal.
I am scheduled for a follow-up on June 6, but since the surgeon did not explain these issues, I am unsure where to find answers.

Xiao Zhu, 40~49 year old female. Ask Date: 2022/05/30

Dr. Zhang Shuhao reply Surgery

During the healing process of the surgical wound, the tissue is more prone to friction and bleeding.
Therefore, there may still be a small amount of bleeding after bowel movements or wiping.
If there are no other symptoms (such as fever or severe pain), you can continue with sitz baths and applying ointment, and return for follow-up as scheduled.

Reply Date: 2022/05/30

More Info

Post-surgery bleeding after hemorrhoid surgery can be a concerning issue, especially when it involves the presence of blood during bowel movements. It is important to understand what to expect during the recovery process and how to manage any complications that may arise.

Firstly, it is not uncommon to experience some bleeding after hemorrhoid surgery, particularly if the surgery involved both internal and external hemorrhoids. The surgical site is healing, and any straining during bowel movements can lead to minor bleeding. This is often due to irritation of the surgical area or the presence of residual swelling. However, if the bleeding is significant or persistent, it is crucial to consult with your healthcare provider.

In your case, it seems that you have been experiencing a cycle of constipation and difficulty with bowel movements, which can exacerbate the situation. After surgery, it is vital to maintain soft stools to minimize straining. Here are some recommendations to help manage your symptoms and promote healing:
1. Hydration: Ensure you are drinking plenty of fluids. Adequate hydration helps soften the stool and makes bowel movements easier.

2. Diet: Incorporate high-fiber foods into your diet, such as fruits, vegetables, whole grains, and legumes. Fiber helps to bulk up the stool and promotes regular bowel movements.

3. Stool Softeners: Continue using stool softeners as prescribed by your doctor. These can help prevent constipation and reduce the risk of straining during bowel movements.

4. Warm Baths: Taking warm sitz baths can help soothe the area and promote relaxation, which may ease discomfort during bowel movements.

5. Avoid Straining: If you feel the urge to go, try to respond promptly. Avoid sitting on the toilet for extended periods, as this can increase pressure on the surgical site.

6. Follow-Up Care: It is essential to keep your follow-up appointments with your healthcare provider. They can assess your healing progress and address any concerns you may have, including the presence of blood during bowel movements.

Regarding the bleeding you experienced after bowel movements, it is not uncommon for some patients to notice a small amount of blood, especially if they are still healing. However, if you notice bright red blood or if the bleeding increases, it is important to seek medical attention. Your healthcare provider may want to evaluate the surgical site to ensure there are no complications, such as infection or reopening of the surgical wound.

In summary, while some bleeding can be expected after hemorrhoid surgery, it is crucial to manage your bowel health proactively to minimize complications. If you continue to experience bleeding or have concerns about your recovery, do not hesitate to reach out to your healthcare provider for guidance and support. They can provide personalized advice based on your specific situation and help ensure a smooth recovery process.

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