Post-Surgery Pain During Bowel Movements: Your Symptoms

Post-operative pain during bowel movements after mole removal?

Hello doctor, I underwent a third-degree hemorrhoidectomy and anal fissure surgery on July 26, and I opted for self-paid ultrasonic scalpel treatment.
Postoperatively, the wound is not very painful, but I experience significant pain during bowel movements.
It has been over a month since the surgery, and I still have pain during bowel movements, and my stools have become thinner.
There is also some bleeding after bowel movements.
During my follow-up appointment last week, the surgeon mentioned that recovery would take about a month and a half.
I am very concerned that this might be an issue of anal stenosis after researching online.
I can't distinguish whether the current pain is from the wound or from what is referred to as anal stenosis.
If I experience pain when passing gas before a bowel movement, does that indicate it is wound pain? Will the thinning of my stools return to normal over time? Thank you.

An Dong Ni, 40~49 year old female. Ask Date: 2022/09/01

Dr. Zhang Shuhao reply Surgery

Early hemorrhoid surgery often resulted in anal stenosis due to injury to the sphincter muscle.
However, with advancements in current hemorrhoid surgical techniques, the occurrence of anal stenosis has significantly decreased.
Based on your description, it seems that the wound has not yet healed, and the pain may be caused by friction during bowel movements or straining.
If the hemorrhoids were larger preoperatively or if an additional sphincter relaxation procedure was performed, it could prolong the healing time of the wound.
It is recommended to take warm sitz baths, increase fluid intake to prevent constipation, and use stool softeners along with anti-inflammatory and pain relief medications.
The narrowing of the stool will return to normal once the pain subsides.
If you have concerns, it is advisable to schedule regular follow-up appointments to monitor the wound.

Reply Date: 2022/09/01

More Info

Post-surgery pain during bowel movements can be a distressing experience, especially after procedures like pilonidal cyst excision and anal fissure surgery. It’s understandable that you are concerned about your symptoms, particularly since it has been over a month since your surgery and you are still experiencing significant pain during bowel movements, along with changes in your stool consistency and the presence of blood.

Firstly, it is important to recognize that pain during bowel movements can arise from several factors. After surgery, the tissues around the surgical site can be sensitive and inflamed, which may lead to pain when straining or passing stool. The fact that you are experiencing pain during bowel movements, as well as after passing gas, suggests that the surgical site may still be healing. Additionally, if you are experiencing blood after bowel movements, this could indicate irritation or trauma to the surgical site, or potentially a complication such as an anal fissure.

The narrowing of the anal canal, known as anal stenosis, can occur after surgery, particularly if there has been significant tissue removal or scarring. This condition can lead to thinner stools, as you have described, and can cause pain during bowel movements. It is essential to differentiate whether the pain you are experiencing is due to the surgical site healing or if it is indeed related to anal stenosis.
In terms of management, here are several strategies that may help alleviate your symptoms:
1. Dietary Modifications: Increasing your fiber intake can help soften your stool, making it easier to pass. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated is crucial, as it helps prevent constipation and reduces straining during bowel movements.

2. Stool Softeners: Over-the-counter stool softeners can be beneficial in easing the passage of stool. These medications work by increasing the water content in your stool, making it softer and easier to pass.

3. Warm Baths: Taking warm sitz baths can help soothe the area and promote relaxation of the anal sphincter, which may alleviate pain during bowel movements.

4. Pain Management: If you are experiencing significant pain, over-the-counter pain relievers such as ibuprofen or acetaminophen may provide relief. However, consult your doctor before taking any medication to ensure it is appropriate for your situation.

5. Follow-Up with Your Surgeon: Since you are still experiencing pain and changes in your bowel habits, it is crucial to follow up with your surgeon or healthcare provider. They may want to examine you to rule out any complications, such as anal stenosis or persistent fissures, and to assess the healing of the surgical site.

6. Physical Therapy: In some cases, pelvic floor physical therapy can be beneficial for individuals experiencing pain after anal surgery. A physical therapist can provide exercises and techniques to help relax the pelvic floor muscles and improve bowel function.

7. Avoid Straining: It is important to avoid straining during bowel movements, as this can exacerbate pain and lead to further complications. If you feel the urge to go but are experiencing pain, consider waiting until you feel more comfortable.

In conclusion, while some discomfort after surgery is expected, persistent pain during bowel movements, changes in stool consistency, and the presence of blood should be addressed with your healthcare provider. They can provide a thorough evaluation and determine the best course of action to help you recover fully. Remember, healing takes time, and it is essential to be patient with your body as it recovers from surgery.

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