Blood in Stool After Hemorrhoid Surgery: Causes and Remedies

Blood in the stool?

Hello, doctor.
I recently underwent a hemorrhoid ligation surgery (three hemorrhoids), but in the past few days, I've noticed bright red blood on the toilet paper after straining during bowel movements.
I went to see the doctor who performed the ligation for a check-up (to rule out the possibility of tumors), and he mentioned that my skin is too sensitive, which makes the anal ligation site prone to bleeding.
He administered two injections, which seemed to be a sclerosing agent.
However, after returning home, I still notice a little bright red blood on the toilet paper whenever I strain, although there isn't much blood in the toilet or in the stool.
What can I do to stop the bleeding? Are there any dietary considerations I should be aware of? Can I eat high-fiber foods? Thank you!

Peter, 60~69 year old female. Ask Date: 2023/03/18

Dr. Ke Fangxu reply Surgery

If there is mild bleeding, it is usually not a concern as long as a colonoscopy has been performed to rule out the possibility of tumors.
High-fiber foods can be consumed, but spicy and irritating foods should be avoided.
Additionally, it is important to shorten the duration of bowel movements.
If bleeding persists, a physician may prescribe medication to help with hemostasis.

Reply Date: 2023/03/18

More Info

Experiencing blood in the stool after hemorrhoid surgery can be concerning, and it's important to understand the potential causes and remedies for this situation. Hemorrhoid surgery, particularly procedures like rubber band ligation, can lead to various postoperative complications, including bleeding.

Causes of Blood in Stool After Hemorrhoid Surgery
1. Surgical Trauma: The most common reason for bleeding after hemorrhoid surgery is trauma to the surgical site. The area around the anus is sensitive, and any strain during bowel movements can cause the delicate tissue to bleed. This is especially true if the skin around the surgical site is still healing.

2. Constipation and Straining: After surgery, patients may experience constipation due to pain or changes in diet. Straining during bowel movements can exacerbate bleeding, as it puts additional pressure on the healing tissues.

3. Infection: Although less common, an infection at the surgical site can lead to inflammation and bleeding. Signs of infection may include increased pain, swelling, or discharge.

4. Underlying Conditions: Conditions such as anal fissures or other gastrointestinal issues can also contribute to bleeding. It’s good that your doctor has ruled out tumors, but other conditions should still be considered.

Remedies and Treatment
1. Dietary Adjustments: A high-fiber diet is crucial for preventing constipation and promoting regular bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated by drinking plenty of water can help soften stools.

2. Stool Softeners: Over-the-counter stool softeners can be beneficial in easing bowel movements and reducing the need to strain. This can help minimize trauma to the surgical site.

3. Avoid Straining: When using the bathroom, try to relax and avoid straining. If necessary, consider using a footstool to elevate your feet while sitting on the toilet, which can help facilitate easier bowel movements.

4. Topical Treatments: Your doctor may recommend topical treatments or medications to help soothe the area and promote healing. The injections you received may have been aimed at reducing inflammation and promoting healing.

5. Follow-Up Care: It’s essential to maintain communication with your healthcare provider. If the bleeding persists or worsens, or if you experience other symptoms such as severe pain, fever, or changes in bowel habits, you should seek medical attention promptly.

6. Rest and Recovery: Allow your body time to heal. Avoid heavy lifting or strenuous activities that could put pressure on the surgical site.

Monitoring Your Condition
Keep a close eye on your symptoms. If you notice that the bleeding increases, or if you see blood in your stool (rather than just on the toilet paper), it’s important to contact your healthcare provider. They may want to conduct further examinations to ensure there are no complications.

Conclusion
In summary, while it’s not uncommon to experience some bleeding after hemorrhoid surgery, it’s crucial to manage your diet, avoid straining, and follow up with your doctor as needed. High-fiber foods are beneficial, and staying hydrated is key. If symptoms persist, don’t hesitate to seek further medical advice. Your health and comfort are paramount, and your healthcare team is there to support you through your recovery.

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