Post-Surgery Care: Managing Discomfort After Fistula and Hemorrhoid Surgery

Post-fistula surgery

I'm sorry, doctor.
I had a fistula surgery and hemorrhoid surgery on August 5th, and today, August 9th, I have an involuntary urge to push at my anus, feeling like I need to have a bowel movement, but I don't actually need to go.
Even after having a bowel movement, I still have this sensation.

1.
Is this normal?
2.
The doctor prescribed me a stool softener, but after taking it, I have experienced mild diarrhea and the urge to have bowel movements multiple times.
Should I stop taking it?
3.
After a sitz bath, do I always need to apply ointment?
4.
After a sitz bath, should I dry the wound area before applying ointment, or can I apply the ointment directly?
5.
After having a bowel movement, can I first wipe with toilet paper and then rinse with a water bottle, or is it better to rinse directly with the water bottle?
Thank you, doctor, for taking the time to answer.

Ms. Hsu, 10~19 year old female. Ask Date: 2022/08/09

Dr. Zhang Shuhao reply Surgery

1.
Postoperatively, swelling around the wound may cause a persistent urge to defecate, but this does not necessarily indicate the presence of stool.
If squatting yields no results, avoid straining and try again later.
Taking warm sitz baths can help reduce swelling around the wound.

2.
If you did not experience constipation prior to surgery, there is no need to take a stool softener, as diarrhea can irritate the wound more.
It is best to allow bowel movements to occur naturally.
3.
If the surrounding skin appears red, apply a thinner layer of ointment or limit application to morning and evening.
Redness or itching may indicate an allergic reaction to the topical medication.
4.
Gently pat the area dry with toilet paper to avoid direct friction on the wound before applying ointment.
5.
After a bowel movement, you can rinse the area directly.

Reply Date: 2022/08/09

More Info

After undergoing fistula and hemorrhoid surgery, it is common to experience a range of discomforts and changes in bowel habits. Your concerns are valid, and I will address each of your questions while providing additional insights into post-surgical care.

1. Feeling of Urgency: It is not uncommon to feel a sense of urgency or pressure in the anal area after such surgeries. This sensation can be attributed to the healing process and the manipulation of tissues during surgery. The body is adjusting to the changes, and the nerves in the area may still be sensitive. If this feeling persists or worsens, it is advisable to consult your surgeon for further evaluation.

2. Softener and Diarrhea: If you are experiencing diarrhea after taking the stool softeners, it may be wise to pause their use and discuss this with your doctor. While stool softeners are intended to ease bowel movements, they can sometimes lead to loose stools, especially if taken in excess or if your diet is already high in fiber. Your doctor may suggest adjusting the dosage or trying a different approach to manage your bowel movements.

3. Post-Sitz Bath Care: After a sitz bath, applying a medicated ointment is generally recommended to promote healing and reduce discomfort. The ointment can help protect the surgical site from irritation and infection. However, it is essential to follow your surgeon's specific instructions regarding the use of ointments.

4. Applying Ointment After Bathing: It is advisable to gently pat the area dry with a clean towel before applying any ointment. This helps to prevent trapping moisture, which could lead to infection. If your surgeon has given specific instructions regarding how to apply the ointment, be sure to follow those.

5. Post-Bowel Movement Hygiene: After a bowel movement, using a water bottle to rinse the area is often recommended, as it can be gentler than wiping with toilet paper. If you prefer to use toilet paper first, ensure that you are very gentle to avoid irritation. The key is to keep the area clean without causing additional trauma to the surgical site.

Additional Considerations for Post-Surgery Care:
- Pain Management: It is normal to experience some pain and discomfort after surgery. Over-the-counter pain relievers may help, but consult your doctor before taking any medication, especially if you are already on prescribed pain management.

- Dietary Adjustments: A high-fiber diet can help regulate bowel movements and prevent constipation, which is crucial after hemorrhoid surgery. However, if you are experiencing diarrhea, you may need to adjust your fiber intake temporarily.

- Hydration: Staying well-hydrated is essential for recovery. Adequate fluid intake can help soften stools and promote healing.

- Activity Level: Avoid strenuous activities and heavy lifting for a few weeks post-surgery. Gentle walking can promote circulation and aid in recovery.

- Signs of Complications: Be vigilant for signs of complications, such as increased pain, fever, or unusual discharge from the surgical site. If you notice any of these symptoms, contact your healthcare provider immediately.

- Follow-Up Appointments: Regular follow-ups with your surgeon are crucial to monitor your recovery. Do not hesitate to reach out to your healthcare provider with any concerns or questions that arise during your recovery process.

In summary, while some discomfort and changes in bowel habits are expected after fistula and hemorrhoid surgery, it is essential to communicate with your healthcare provider about any persistent or concerning symptoms. They can provide personalized advice and adjustments to your care plan to ensure a smooth recovery.

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