Managing Recurring Hemorrhoids After Surgery: A Patient's Journey - Surgery

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Recurrence of hemorrhoids after surgery?


Hello Dr.
Ke: My husband underwent hemorrhoid surgery at National Taiwan University several years ago.
Initially, everything was normal post-surgery, but due to severe anxiety over the past six months, he has experienced a loss of appetite and irregular meals, leading to constipation and a recurrence of hemorrhoids.
He now has bowel movements only every few days, and each time it takes a long time to pass, accompanied by significant pain and discomfort.
He is very reluctant to seek care from a colorectal surgeon again, so he has been using suppositories (which have not significantly improved his symptoms).
Recently, he learned about a medication called Aiofulong, and after taking it for a few days, he had a smooth bowel movement today without pain.
The only issue is that he is experiencing noticeable side effects such as headaches and dizziness (which are mentioned in the leaflet).
I am unsure whether he should continue taking it.
Additionally, is this medication suitable for long-term use, or is it only intended for short-term symptom relief? (According to him, he has internal hemorrhoids that do not protrude, but the pain may indicate mild external hemorrhoids?) Thank you very much.

Xiao Mimi, 40~49 year old female. Ask Date: 2022/10/23

Dr. Ke Fangxu reply Surgery


After hemorrhoid surgery, it is generally possible to remain symptom-free for up to ten years.
However, if good bowel habits and dietary practices are not maintained, recurrence of symptoms within 1-2 years is also a common occurrence.
Aiofuro is a type of venous constrictor and vascular protector, which is effective, but it is important to note that all medications should not be taken long-term unless absolutely necessary.
The key is to address anxiety and constipation issues, as this is the fundamental approach to prevention.

Reply Date: 2022/10/23

More Info


Managing recurring hemorrhoids after surgery can be a challenging journey, especially when compounded by psychological factors such as anxiety and changes in dietary habits. Your husband's situation, where he has experienced a resurgence of hemorrhoids due to constipation and irregular bowel movements, is not uncommon. Let's delve into the management strategies and considerations for his condition.

Firstly, it's important to understand that hemorrhoids can recur after surgical intervention, particularly if the underlying causes, such as constipation, are not adequately addressed. In your husband's case, the anxiety and poor appetite leading to infrequent and painful bowel movements are significant contributors to his current symptoms. The pain and discomfort associated with hemorrhoids can create a vicious cycle, where fear of pain leads to avoidance of bowel movements, further exacerbating constipation and hemorrhoid issues.

The use of topical treatments, such as suppositories, can provide temporary relief, but they may not address the root cause of the problem. It’s encouraging to hear that your husband has found some relief with the medication you mentioned,艾歐復隆 (likely referring to a laxative or stool softener), which has helped him have smoother bowel movements. However, the side effects of headache and dizziness are concerning and warrant careful consideration.

Regarding the long-term use of艾歐復隆 or similar medications, it is generally advisable to use such medications for a limited duration. While they can be effective in managing symptoms, relying on them long-term can lead to dependency, where the bowel becomes less able to function normally without the aid of medication. Instead, a more sustainable approach would involve lifestyle modifications aimed at preventing constipation and promoting regular bowel movements.

Here are some strategies that may help your husband manage his condition more effectively:
1. Dietary Changes: Encourage a high-fiber diet rich in fruits, vegetables, whole grains, and legumes. Fiber helps to soften stool and promote regular bowel movements. Additionally, adequate hydration is crucial—encourage him to drink plenty of water throughout the day.

2. Regular Exercise: Physical activity can stimulate bowel function and help alleviate constipation. Even simple activities like walking can be beneficial.

3. Bowel Habits: Establishing a regular bowel routine can help. Encourage him to set aside time each day to attempt a bowel movement, ideally after meals when the digestive system is more active.

4. Stress Management: Since anxiety is a significant factor in his current condition, exploring stress-reduction techniques such as mindfulness, meditation, or counseling may be beneficial. Addressing the psychological aspects can have a positive impact on his physical health.

5. Consultation with a Specialist: If your husband is resistant to seeing a colorectal surgeon, perhaps a consultation with a gastroenterologist could be a less intimidating option. They can provide insights into managing his symptoms and may suggest alternative treatments or therapies.

6. Monitoring Symptoms: Keep track of his symptoms and any side effects from medications. If the headaches and dizziness persist, it may be necessary to consult with a healthcare provider to reassess his medication regimen.

In conclusion, while medications like艾歐復隆 can provide temporary relief, a comprehensive approach that includes dietary changes, lifestyle modifications, and psychological support will likely yield better long-term results. Encourage your husband to consider these strategies and to seek professional guidance, as managing recurring hemorrhoids effectively often requires a multifaceted approach.

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