Post-Surgery Concerns: Gas and Dietary Restrictions After Hemorrhoid Surgery

Postoperative condition after traditional hemorrhoid surgery?

Hello Dr.
Chang, I would like to ask you a question.
I have hemorrhoids and underwent traditional hemorrhoid surgery on June 23 at a hospital.
It has now been a month since the surgery.
During my follow-up appointment last week, the doctor assessed my condition and I reported that everything is going well.
The doctor performed a visual examination but did not conduct a digital rectal exam or anoscopy, and advised me that I do not need to return for follow-up unless there are issues.

Currently, I have been experiencing excessive flatulence post-surgery; sometimes it occurs, and sometimes it does not, but I find that I am particularly gassy every morning and evening.
Is this a normal phenomenon, or could it be due to something else? Should I schedule another follow-up appointment? Before the surgery, I did not experience this level of flatulence, but it started about two weeks after the operation.
I often forget to ask the doctor about this during my visits, as I focus more on the wound healing.

Additionally, I am concerned about the possibility of recurrence after undergoing traditional hemorrhoid surgery.
I am quite worried about this.
Since it has been a month since my surgery, are there any dietary restrictions I should still follow? For example, should I avoid spicy foods, fried foods, pepper, salt, smoking, and alcohol, or can I reintroduce these items into my diet?

Xiao Feng, 30~39 year old female. Ask Date: 2023/07/24

Dr. Zhang Shuhao reply Surgery

1.
Postoperative hemorrhoids will not affect the frequency of flatulence; however, sometimes stool softeners or fiber supplements may be added after surgery, as these medications can promote intestinal motility.
After discontinuation of the medication, bowel function will return to normal naturally.

2.
The recurrence rate of traditional hemorrhoid surgery is extremely low within five years, as long as good dietary and bowel habits are maintained, recurrence is unlikely.

3.
Typically, the surgical wound will be fully healed within one month postoperatively.
In terms of diet, as long as it does not cause constipation or diarrhea, there is no need for strict dietary restrictions.

Reply Date: 2023/07/24

More Info

After undergoing hemorrhoid surgery, it's common for patients to experience various gastrointestinal changes, including increased flatulence. This can be attributed to several factors related to the surgical procedure and the healing process. Here’s an overview of what you might expect post-surgery, along with dietary recommendations and concerns regarding gas and the potential for recurrence of hemorrhoids.

Understanding Post-Surgery Gas
1. Surgical Impact: Hemorrhoid surgery, particularly traditional methods, can affect the surrounding tissues and nerves in the anal region. This can lead to changes in bowel habits and gas production. The manipulation of the rectal area may temporarily alter how gas is expelled, leading to increased flatulence.

2. Dietary Changes: Post-surgery, many patients are advised to adopt a high-fiber diet to promote regular bowel movements and prevent constipation, which is crucial for healing. However, certain high-fiber foods can also lead to increased gas production. Foods such as beans, lentils, broccoli, and carbonated beverages are known to cause gas. If you have recently increased your fiber intake, this could be a contributing factor.

3. Gut Flora Adjustment: After surgery, your gut microbiome may take some time to adjust, especially if you have changed your diet significantly. This adjustment can lead to increased gas production as your body adapts to new foods.

Dietary Recommendations
1. Avoid Irritants: It is advisable to avoid spicy foods, alcohol, and caffeine for at least a few weeks post-surgery. These can irritate the digestive tract and exacerbate symptoms such as gas and discomfort.

2. Gradual Fiber Introduction: If you are increasing fiber intake, do so gradually. This allows your digestive system to adjust without overwhelming it. Incorporate soluble fibers (like oats and fruits) that are generally easier to digest before adding insoluble fibers (like whole grains and raw vegetables).

3. Stay Hydrated: Drinking plenty of water is essential, especially when increasing fiber intake. Adequate hydration helps prevent constipation and supports overall digestive health.

4. Monitor Your Body's Response: Keep a food diary to track what you eat and how it affects your gas production. This can help you identify specific foods that may be causing excessive gas.

Recurrence of Hemorrhoids
Regarding your concern about the recurrence of hemorrhoids, it is important to note that while surgery can effectively treat existing hemorrhoids, lifestyle factors play a significant role in preventing their return. Here are some tips to minimize the risk of recurrence:
1. Maintain Regular Bowel Movements: Avoid straining during bowel movements, as this can increase pressure on the rectal veins. A high-fiber diet, combined with adequate hydration, can help maintain regularity.

2. Avoid Prolonged Sitting: If your job involves sitting for long periods, take regular breaks to stand and move around. This can help reduce pressure on the rectal area.

3. Exercise Regularly: Engaging in regular physical activity can improve bowel function and reduce the risk of constipation.

4. Listen to Your Body: If you experience symptoms such as pain, bleeding, or significant changes in bowel habits, consult your healthcare provider promptly.

Conclusion
In summary, experiencing increased flatulence after hemorrhoid surgery can be a normal part of the healing process. However, it is essential to monitor your symptoms and make dietary adjustments as needed. Avoiding irritants and gradually increasing fiber intake while staying hydrated can help manage gas production. If you have ongoing concerns or if your symptoms worsen, it would be wise to follow up with your healthcare provider for further evaluation. Remember, maintaining a healthy lifestyle is key to preventing the recurrence of hemorrhoids.

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