Post-Surgery Hemorrhoid Care: Managing Bleeding and Recovery Tips

Persistent bleeding after hemorrhoid surgery?

Hello Doctor, I just underwent traditional surgery for thrombosis and hemorrhoids on Monday, and I am currently recovering at home.

Question 1: Since I have a larger body frame, the doctor advised me to use a sitz bath whenever I go to the restroom.
After using the toilet, I switch to a new basin of water for another sitz bath, but I still find that I cannot clean the anal area thoroughly, and there is still some bleeding.
Is there a better method for cleaning?
Question 2: After moving around or waking up, I notice blood stains on my underwear.
Is this a normal occurrence? I am quite worried that it might be a sign of infection at the wound site.
I considered placing tissue or gauze between my buttocks, but will that affect the healing of the wound?
Question 3: The doctor has instructed me to only drink Ovaltine with nutritional supplements for a week.
Currently, my bowel movements are quite loose.
Does this count as a semi-liquid diet? Can I switch to drinking soy milk, clear broth, or rice soaked in soup?
Question 4: Since I will be returning to work soon and will need to be active, I am quite concerned about worsening the wound.
What preventive measures can I take?
Thank you for your assistance with these questions!

Ai Meishi, 30~39 year old female. Ask Date: 2022/07/29

Dr. Zhang Shuhao reply Surgery

1.
After using the restroom, you can use a bidet or clean water to wash yourself.
Avoid using a strong water stream and do not wipe too hard.
If there is bleeding, you can apply ointment and cover it with gauze while applying slight pressure.

2.
The surgical wound is prone to bleeding due to friction before it has healed.
You can cover it with gauze to avoid direct contact.
At home, try to wear loose-fitting clothing to keep the wound ventilated.

3.
To avoid irritation to the wound during bowel movements post-surgery, you can reduce your food intake, but it should not be overly restrictive.
The focus should be on not feeling hungry or uncomfortable, and a light diet is acceptable.

4.
Wear loose clothing and use a hemorrhoid cushion.
Take short walks during breaks to avoid prolonged pressure.
If possible, take warm sitz baths and avoid heavy lifting or strenuous activities.

Reply Date: 2022/07/29

More Info

Post-surgery care for hemorrhoids, especially after a thrombectomy and traditional excision, is crucial for a smooth recovery and to minimize complications. Here are detailed answers to your questions, along with some additional tips for managing bleeding and ensuring a successful recovery.

Question 1: Cleaning After Bowel Movements
It’s common to experience some difficulty in cleaning the anal area after surgery, especially if you are advised to use sitz baths. Here are some suggestions to improve your cleaning routine:
1. Gentle Cleaning: Use soft, unscented wipes or moistened toilet paper instead of dry toilet paper. This can help reduce irritation and ensure a cleaner area.

2. Sitz Baths: Continue with sitz baths as they can help soothe the area and promote healing. You might consider adding Epsom salts to the water, as they can help reduce inflammation.

3. Hydration and Diet: Ensure you are drinking plenty of fluids and consuming a high-fiber diet to soften your stools. This will make bowel movements easier and reduce straining, which can exacerbate bleeding.

4. Consult Your Doctor: If bleeding persists or worsens, it’s essential to consult your healthcare provider. They may need to assess the surgical site for any complications.

Question 2: Blood Stains on Underwear
Seeing blood stains on your underwear after surgery can be concerning, but it’s not uncommon. Here’s what to consider:
1. Normal Post-Operative Bleeding: Some bleeding can occur as part of the healing process. However, if the bleeding is significant or accompanied by pain, it’s important to seek medical advice.

2. Dressing the Area: Using a clean, soft pad or gauze can help absorb any discharge without irritating the wound. Make sure to change it regularly to keep the area clean and dry.

3. Avoiding Infection: If you notice any signs of infection, such as increased redness, swelling, or pus, contact your doctor immediately.

Question 3: Diet After Surgery
Your current diet of drinking a nutritional supplement like Horlicks is a good start, but you can expand your options:
1. Fluid Intake: Yes, you can incorporate other liquids like soy milk, clear broth, or soup. These can help maintain hydration and provide some nutrients.

2. Soft Foods: Gradually introduce soft foods that are easy to digest, such as mashed potatoes, oatmeal, or yogurt. Avoid spicy or heavy foods that could irritate your digestive system.

3. Monitor Bowel Movements: If your stools remain too loose, consider adjusting your diet to include more binding foods like bananas or rice.

Question 4: Returning to Work
As you prepare to return to work, it’s important to take precautions to avoid straining or aggravating your surgical site:
1. Gradual Return: If possible, start with shorter workdays or flexible hours to allow your body to adjust.

2. Frequent Breaks: Take regular breaks to sit down and rest. Avoid prolonged standing or walking, which can increase pressure on the surgical site.

3. Supportive Garments: Wearing supportive underwear can help provide comfort and reduce movement that might irritate the area.

4. Follow-Up Appointments: Keep all follow-up appointments with your healthcare provider to monitor your recovery and address any concerns.

Additional Tips for Recovery
- Pain Management: Use prescribed pain medications as directed. Over-the-counter pain relievers may also help, but consult your doctor first.

- Avoid Straining: When using the bathroom, avoid straining. If you feel constipated, consider a stool softener after consulting your doctor.

- Hygiene: Maintain good hygiene by washing the area gently with mild soap and water, and patting dry instead of rubbing.

In summary, while some bleeding and discomfort are normal after hemorrhoid surgery, it’s essential to monitor your symptoms closely and maintain good hygiene and dietary practices. If you have any concerns or if symptoms worsen, don’t hesitate to reach out to your healthcare provider for guidance. Your recovery is important, and taking proactive steps can help ensure a smoother healing process.

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