Post-Surgery Concerns: Managing Hemorrhoid Surgery Recovery Issues

One month after undergoing traditional hemorrhoid surgery, I encountered some issues?

Hello Dr.
Ke, I would like to ask you a question.
I have internal hemorrhoids and underwent traditional hemorrhoid surgery at a hospital on June 23rd, which was over a month ago.
During my follow-up appointment on July 17th, the doctor assessed my condition and I reported that everything was fine.
The doctor performed a visual examination but did not conduct a digital rectal exam or anoscopy, and advised me that I did not need to return unless I had concerns.
This morning, I experienced difficulty passing a hard stool and had to strain to do so.
Once it was at the anal opening, I was able to pass it, but I noticed what appeared to be a small amount of blood in the toilet.
I initially thought it might be something else and did not pay much attention to it, but I did feel slight pain at the anal opening afterward.
I rinsed the area with water instead of using toilet paper.
By noon, I had a bowel movement again without straining, and after this natural passage, I again noticed a small amount of blood in the toilet, along with the same slight pain at the anal opening.
I rinsed the area again.
I am now quite worried that this might affect the healing of my surgical site or that the wound, which may have already healed, could be injured again by the hard stool.
I am also concerned about the possibility of bleeding again during my next bowel movement, and I fear it could be significant.
The doctor prescribed me stool softeners and hemostatic medication, which I am managing myself.
I take the stool softeners regularly; for example, if I don't take them one day, I will take them the next day.
Dr.
Ke, do you think I need to return to my primary physician for an examination, or should I just monitor the situation? Additionally, since my hemorrhoid surgery, I have been having bowel movements 1 to 3 times a day, with a maximum of 4 times when taking the stool softeners.
Sometimes I only go once a day.
Is this normal? Could this be a sign of irritable bowel syndrome?

Xiao Feng, 30~39 year old female. Ask Date: 2023/08/03

Dr. Ke Fangxu reply Surgery

It is possible that straining during bowel movements can cause bleeding from the surgical site.
After surgery, it is important to avoid constipation.
You can continue taking your usual medications as long as there is no significant bleeding or severe pain.
After hemorrhoid surgery, increased bowel movements may occur due to irritation of the surgical site, but this will improve as the wound heals.

Reply Date: 2023/08/03

More Info

After undergoing hemorrhoid surgery, it is common for patients to experience a range of recovery issues, including pain, bleeding, and changes in bowel habits. Based on your description, it seems you are experiencing some concerns that are not uncommon after such a procedure.

Firstly, the presence of blood in your stool, especially if it is just a small amount, can be a normal occurrence following hemorrhoid surgery. This can happen due to irritation or minor trauma to the surgical site, especially if you are experiencing hard stools that require straining. Straining during bowel movements can put pressure on the healing tissue and potentially cause bleeding. It is crucial to manage your bowel movements to minimize this risk.

You mentioned that you are taking softening medications, which is a positive step. Maintaining soft stools is essential for preventing further irritation or injury to the surgical site. If you find that you are still experiencing hard stools despite taking softeners, you may want to consider increasing your fluid intake, consuming more fiber-rich foods, or discussing with your doctor the possibility of adjusting your medication regimen.
Regarding the pain you are experiencing, mild discomfort can be expected as part of the healing process. However, if the pain becomes severe or is accompanied by significant bleeding, you should seek medical attention. It is also important to monitor for any signs of infection, such as increased redness, swelling, or discharge from the surgical site.

As for your bowel habits, having 1 to 3 bowel movements a day can be normal, especially if you are taking medications to soften your stool. However, if you notice a significant change in your bowel habits or if you experience symptoms such as cramping, urgency, or diarrhea, it may be worth discussing with your healthcare provider. These symptoms could indicate a condition such as irritable bowel syndrome (IBS), but they could also be a reaction to the surgery or medications.

In terms of follow-up care, it is advisable to reach out to your surgeon or healthcare provider to discuss your concerns, especially since you are experiencing bleeding and pain. They may want to perform a physical examination or other assessments to ensure that your recovery is on track and that there are no complications. It is always better to err on the side of caution when it comes to post-surgical recovery.

In summary, while some bleeding and discomfort can be normal after hemorrhoid surgery, it is essential to manage your bowel movements carefully and monitor your symptoms. If you have any doubts or if your symptoms worsen, do not hesitate to contact your healthcare provider for further evaluation and guidance. Your recovery is important, and addressing any concerns promptly can help ensure a smoother healing process.

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