Post-Surgery Pain Management After Hemorrhoid Surgery: What to Expect

Inquiry about postoperative pain after tissue coagulation knife procedure?

Hello Dr.
Chang, I am suffering from grade III internal hemorrhoids and have already undergone surgery at a major hospital.
The procedure seemed to involve a tissue coagulation device, not laser treatment.
Initially, the doctor informed me that the wound would heal in two weeks, but it has now been 30 days post-surgery.
I experience mild pain during bowel movements and occasionally feel a slight pain on the right side while walking.
I have consulted with the surgeon who performed the operation, and he said the wound has healed, attributing my pain to heightened sensitivity.
He did not specify when the pain would subside and mentioned that there is no infection.
I also requested antibiotics from him.
Currently, I am doing warm sitz baths twice a day and using medication during bowel movements.

1.
The doctor advised me that I no longer need to apply Neomycin ointment and prescribed me a stronger topical medication.

2.
I still have a little discharge, and I would like to ask Dr.
Chang if this situation is normal, as I am quite worried.
Others seem to have fully recovered within a month after their surgery.

Xiao Tu, 20~29 year old female. Ask Date: 2023/12/21

Dr. Zhang Shuhao reply Surgery

1.
The LigaSure device is a literature-validated surgical method that results in lower levels of pain and bleeding compared to traditional surgery.
If the wound has fully healed, antibiotic ointment is not necessary.
Strongly applied analgesics can help soothe the wound and relieve pain, and they can be used as directed by the physician to alleviate symptoms.

2.
Mild discomfort and discharge from the wound after surgery are normal.
Each individual's physiology is different, and the healing process of the wound may vary.
As long as symptoms gradually improve, there is no need for concern.

Reply Date: 2023/12/21

More Info

Post-surgery pain management after hemorrhoid surgery can be a significant concern for many patients. It's important to understand what to expect during the recovery process and how to effectively manage any discomfort that may arise.

Firstly, it's essential to recognize that hemorrhoid surgery, particularly for third-degree hemorrhoids, can lead to varying levels of pain and discomfort during the recovery phase. The use of a tissue coagulation knife, as mentioned in your case, is a common method for this type of surgery, and while it can minimize some risks associated with traditional excisional surgery, it does not eliminate the potential for postoperative pain.

In your situation, experiencing mild pain during bowel movements and occasional discomfort while walking is not unusual, especially considering that it has been 30 days since your surgery. Healing times can vary significantly from person to person, and while your surgeon indicated that the wound has healed, individual sensitivity to pain can differ. Some patients may experience heightened sensitivity in the surgical area, which can contribute to ongoing discomfort even after the physical healing has occurred.

The fact that you are still experiencing some discharge is also not uncommon. Postoperative discharge can occur as part of the healing process, and as long as there are no signs of infection (such as increased redness, swelling, or pus), this may be considered a normal part of recovery. However, it is always wise to keep an open line of communication with your healthcare provider regarding any concerns you may have.

Regarding your current pain management regimen, it is good to hear that you are practicing warm sitz baths, as this can help soothe the area and promote healing. The use of topical medications, such as the prescribed strong ointment, can also provide relief. If your doctor has advised against the use of Neomycin ointment, it may be because they believe that the new medication is more appropriate for your current condition.

If you continue to experience pain beyond what is expected or if your symptoms worsen, it would be advisable to follow up with your surgeon or a gastroenterologist. They can assess your situation more thoroughly and determine if further intervention is necessary. It's crucial to address any concerns you have about your recovery, as early intervention can often prevent more significant issues down the line.

In summary, while it is understandable to be anxious about your recovery, the symptoms you describe can be part of the normal healing process after hemorrhoid surgery. Continue to follow your doctor's recommendations, maintain good hygiene, and manage your pain with the prescribed medications. If your symptoms persist or worsen, do not hesitate to seek further medical advice. Remember, every patient's recovery journey is unique, and it is essential to be patient with your body as it heals.

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