Post-Surgery Bowel Movements: Coping with Pain After Hemorrhoid Surgery

Postoperative bowel movement

Hello Doctor: I had minimally invasive surgery for hemorrhoids six days ago.
Until a few days ago, everything was normal with warm sitz baths and bowel movements.
However, during my sitz bath today, I suddenly experienced severe stabbing pain in my anus, accompanied by a strong urge to defecate.
I feel like I need to go but can't due to the pain, similar to the experience of childbirth.
The pain is so intense that I ended up kneeling on the floor crying, even though I have taken the pain medication prescribed by my doctor.
There is still a small amount of stool in the bath (without blood).
I have asked my doctor, and they said this is normal, but the pain is unbearable.
What can I do to improve this situation?

Huang Wei-zhe, 10~19 year old female. Ask Date: 2022/08/03

Dr. Zhang Shuhao reply Surgery

If you are unable to pass stool accompanied by severe pain, it may be due to fecal impaction, which can affect wound healing and even lead to infection.
You should immediately return to your original healthcare provider for fecal removal.
If you are able to pass some stool, you can try taking a sitz bath while attempting to have a bowel movement, increase your fluid intake, and use stool softeners to prevent recurrence.

Reply Date: 2022/08/03

More Info

After undergoing hemorrhoid surgery, experiencing pain during bowel movements is not uncommon, especially within the first week post-operation. The pain you describe, particularly the severe stabbing sensation and the inability to pass stool comfortably, can be attributed to several factors related to the surgical procedure and the healing process.

Firstly, it’s important to understand that hemorrhoid surgery, even when minimally invasive, can lead to inflammation and irritation in the anal area. This can result in heightened sensitivity and discomfort during bowel movements. The surgical site may still be healing, and any pressure or straining can exacerbate pain. Additionally, the fear of pain can create a psychological barrier, making it difficult to relax the anal sphincter, which can further complicate bowel movements.

Here are some strategies to help manage your pain and improve your bowel movements post-surgery:
1. Dietary Adjustments: Focus on a high-fiber diet to soften stools and make them easier to pass. Incorporate fruits, vegetables, whole grains, and plenty of fluids into your diet. Staying hydrated is crucial, as it helps prevent constipation, which can lead to straining and increased pain.

2. Stool Softeners: If your doctor has not already prescribed them, consider using over-the-counter stool softeners. These can help ease the passage of stool without straining.

3. Warm Sitz Baths: Continue with warm sitz baths, as they can provide relief from pain and help relax the anal muscles. You might find it beneficial to do this several times a day, especially before attempting to have a bowel movement.

4. Pain Management: Ensure you are taking the prescribed pain medications as directed. If the pain is not adequately controlled, discuss this with your doctor. They may adjust your medication or suggest additional options for pain relief.

5. Gentle Techniques: When you feel the urge to have a bowel movement, try to relax your body and avoid straining. You might find it helpful to take deep breaths or use relaxation techniques to ease the tension in your body.

6. Positioning: Consider your position on the toilet. Elevating your feet with a stool can help align your body in a way that may facilitate easier bowel movements.

7. Follow-Up Care: Since you are experiencing significant pain, it’s essential to maintain open communication with your healthcare provider. If the pain persists or worsens, or if you notice any unusual symptoms (such as bleeding), seek medical attention promptly.

8. Physical Activity: Engage in light physical activity as tolerated. Gentle walking can stimulate bowel function and help alleviate constipation.

9. Avoiding Straining: If you feel the urge to go but are in pain, it’s okay to wait until you feel more comfortable. Forcing a bowel movement can lead to further pain and complications.

In conclusion, while some discomfort is expected after hemorrhoid surgery, severe pain should not be ignored. It’s crucial to address your concerns with your healthcare provider to ensure that your recovery is on track and to explore additional pain management strategies. Remember, healing takes time, and being proactive about your care can significantly improve your comfort and recovery process.

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