Post-Surgery Care for Hemorrhoids: Managing Bleeding and Recovery Tips

Post-hemorrhoid surgery

Hello Dr.
Ke, I underwent a hemorrhoid cryotherapy procedure (internal hemorrhoids) on February 3rd of this year.
During my last follow-up appointment on February 22nd, I mentioned that I sometimes experience minor bleeding during bowel movements, while at other times there is no bleeding at all.
After examination, the doctor stated that the internal hemorrhoids have improved by about 80%, but there is a small area of the surgical site where the mucosa has not healed, which is causing the bleeding.
The doctor reassured me that it is not a concern and prescribed hemostatic medication, but did not prescribe any ointment, stating that I can take the medication if bleeding occurs.
I have a few questions:
1.
How long should I monitor this situation before returning for a follow-up or considering seeing another doctor if there is no improvement?
2.
Is there a possibility of infection or abscess related to this condition?
3.
Since my menstrual period has recently started, it is difficult to distinguish the source of the bleeding.
Currently, after bowel movements, I clean the area and apply petroleum jelly to the external anal skin and about 1.5 fingers deep into the anal canal.
Is this method appropriate?
4.
Before my menstrual period, I have been taking sitz baths, and after those, I also apply petroleum jelly using the same method.
Is this approach acceptable?

Miss Yang, 40~49 year old female. Ask Date: 2023/02/23

Dr. Ke Fangxu reply Surgery

1.
It has only been a week since the surgery, and it is generally recommended to observe for 2-4 weeks before making any decisions.

2.
It should not be the case; if there were an infection, symptoms such as redness, swelling, heat, and pain would typically occur, and sometimes there could be an accumulation of pus.
Currently, it seems that there is none.

3.
It is advisable not to apply any ointment inside the anus for now, as it may affect wound healing or irritate the surgical site.

4.
Please discuss with your surgeon whether it is appropriate to use petroleum jelly or other ointments; the surgeon should provide you with more suitable recommendations.

Reply Date: 2023/02/23

More Info

Post-surgery care for hemorrhoids, particularly after a procedure like a hemorrhoidectomy or the use of a cold coagulation technique, is crucial for ensuring proper healing and minimizing complications. Based on your situation, here are some insights and recommendations regarding your recovery and management of bleeding.

1. Monitoring Recovery: It is essential to keep a close watch on your symptoms. Since you mentioned that you have experienced occasional bleeding during bowel movements, it is advisable to monitor this for a few more weeks. If the bleeding persists or worsens, or if you notice any other concerning symptoms such as increased pain, swelling, or discharge, you should return to your doctor for further evaluation. Generally, if there is no improvement in a month, seeking a second opinion could be beneficial.

2. Infection and Abscess Concerns: Post-surgical infections can occur, especially if there is an open wound or if the surgical site is not kept clean. Signs of infection include increased redness, swelling, warmth, or pus-like discharge from the surgical site. If you experience fever or chills, these could also indicate an infection. An abscess may form if an infection develops, leading to localized pain and swelling. If you have any of these symptoms, it is crucial to contact your healthcare provider immediately.

3. Use of Vaseline: Applying petroleum jelly (like Vaseline) to the anal area can help keep the skin moisturized and reduce friction during bowel movements, which is beneficial for healing. However, ensure that you are applying it gently and not introducing any bacteria into the area. It’s also important to maintain good hygiene by cleaning the area with mild soap and water after each bowel movement.

4. Sitz Baths: Taking sitz baths can be very soothing and beneficial for recovery. They help to keep the area clean, reduce discomfort, and promote blood flow to the region, which can aid healing. After your sitz bath, applying Vaseline is a good practice as it can help protect the area from irritation. Just make sure to dry the area gently after bathing to avoid moisture buildup, which can lead to irritation or infection.

5. Diet and Bowel Movements: To minimize straining during bowel movements, it is essential to maintain a high-fiber diet and stay well-hydrated. This can help prevent constipation and make bowel movements easier and less painful. Consider incorporating fruits, vegetables, whole grains, and plenty of fluids into your diet. If necessary, your doctor may recommend a stool softener to ease bowel movements.

6. Follow-Up Care: Regular follow-up appointments are essential to monitor your recovery. Your doctor may want to check the healing progress of the surgical site and ensure that there are no complications. If you have concerns about the healing process or if the bleeding continues, do not hesitate to reach out to your healthcare provider for advice.

In summary, while some bleeding can be normal during the healing process, it is crucial to monitor your symptoms closely. Maintain good hygiene, use sitz baths, and apply Vaseline as needed. If you notice any signs of infection or if your symptoms do not improve, seek medical attention promptly. Your recovery is important, and following these guidelines can help ensure a smoother healing process.

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