Post-Surgery Bleeding After Hemorrhoid Surgery: What to Do?

One month after hemorrhoid surgery, there is still bleeding?

Hello, doctor! My father had traditional mole removal surgery on May 15, and it has been a month since then.
He is still experiencing bleeding after having soft stools, particularly when he tries to pass the last part.
Is this normal?
A week after the surgery, he had a significant amount of bleeding, and the emergency doctor informed us that it was due to the surrounding skin being abraded.
A week later, we noticed that some sutures had come out, and we wondered if this was causing the ongoing bleeding, so he cut them himself.
However, it seems there are still some suture ends inside, and he was hesitant to handle it further.

During follow-up visits, he informed the doctor, who removed the remaining sutures but did not prescribe any medication, only topical ointment.
Now, he continues to experience bleeding after using the restroom, and we are unsure how to proceed.
We kindly ask for your assistance in addressing this issue.
Thank you!

Liao Xiaojie, 40~49 year old female. Ask Date: 2023/06/19

Dr. Zhang Shuhao reply Surgery

It is common to experience a small amount of bleeding before the wound from hemorrhoid surgery heals, but it rarely persists for more than a month.
Possible reasons for this include delayed wound healing, residual blood vessels from internal hemorrhoids, and bleeding from the newly formed granulation tissue due to friction.
It is recommended to take warm sitz baths frequently, continue applying ointment and changing dressings, and attend regular follow-up appointments to monitor the wound condition, while following the medication instructions provided by the surgeon.

Reply Date: 2023/06/19

More Info

Post-surgery bleeding after hemorrhoid surgery can be concerning, especially when it persists for an extended period. In your father's case, experiencing bleeding after a month post-operation, particularly during bowel movements, warrants careful evaluation and management.
Firstly, it is important to understand that some bleeding can be normal after hemorrhoid surgery, especially if the surgical site is still healing. However, if the bleeding is significant or recurrent, it may indicate complications such as infection, improper healing, or issues related to the surgical technique. The fact that your father experienced a significant amount of bleeding shortly after the surgery and that there were concerns regarding the sutures suggests that close monitoring is essential.

Here are some steps you can take to manage the situation:
1. Consult the Surgeon: Since your father has already experienced complications, it is crucial to keep an open line of communication with the surgeon who performed the procedure. They can provide specific insights based on the surgical technique used and the current state of healing.

2. Monitor Symptoms: Keep track of the bleeding. Note the amount, frequency, and any associated symptoms such as pain, swelling, or changes in bowel habits. If the bleeding is bright red and occurs in significant amounts, it may require immediate medical attention.

3. Avoid Straining: Encourage your father to avoid straining during bowel movements, as this can exacerbate bleeding. A diet high in fiber, along with adequate hydration, can help soften stools and reduce the need for straining.

4. Sitz Baths: Warm sitz baths can promote healing and provide relief from discomfort. This practice can help soothe the surgical area and may assist in reducing inflammation.

5. Topical Treatments: If the doctor has prescribed topical ointments, ensure that they are applied as directed. These can help with pain relief and promote healing.

6. Follow-Up Appointments: Regular follow-ups with the healthcare provider are essential. If the bleeding continues or worsens, further evaluation may be necessary, including imaging studies or possibly a revision of the surgical site.

7. Avoid Self-Treatment: It is understandable to want to manage the situation at home, but avoid self-removing any sutures or attempting to treat the area without professional guidance. This could lead to further complications or infections.

8. Emergency Care: If your father experiences heavy bleeding (more than a few tablespoons), signs of infection (such as fever, increased pain, or pus), or any other concerning symptoms, seek emergency medical care immediately.

In summary, while some bleeding can be expected after hemorrhoid surgery, persistent or significant bleeding should not be ignored. Close communication with the healthcare provider, careful monitoring of symptoms, and adherence to post-operative care instructions are vital for ensuring proper healing and preventing complications.

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