Post-Surgery Bowel Movements: Managing Diarrhea After Modified Ferguson Procedure

Postoperative bowel movements after Modified Ferguson with Ligasure?

Hello, doctor.
I had hemorrhoid surgery on Thursday afternoon.
I took two softening agents in the evening, and I did not have a bowel movement before being discharged the next day.
After returning home, I had watery stools that were unformed.
Last night around midnight, I had a large amount of watery stool, and today at noon, it was also watery.
During this time, I have been passing gas and experiencing bowel sounds, but I do not have any abdominal pain.
I would like to know if this situation is due to the softening agents I took.
Will having diarrhea post-surgery affect the wound? How can I improve this? Should I reduce the dosage? The medications I am taking are as follows: Sennosides / 20mg, two at bedtime; Magnesium Oxide / 250mg, one each morning, noon, and evening; Darling / 1000mg, one each morning, noon, and evening; Meclizine 25mg, one each morning and evening; Diclofenac Pot / 25mg, one each morning, noon, evening, and at bedtime.
Thank you for taking the time to respond, doctor.

C, 30~39 year old female. Ask Date: 2024/01/27

Dr. Zhang Shuhao reply Surgery

If there is loose stool, Sennosides and Magnesium Oxide can be temporarily discontinued.
If there are no severe constipation issues before the surgery, there is no need to take stool softeners after the procedure.
Increase fluid intake, continue warm sitz baths, and if there is no severe pain or significant bleeding from the wound, follow up as scheduled.

Reply Date: 2024/01/27

More Info

After undergoing a Modified Ferguson procedure for hemorrhoids, experiencing diarrhea can be concerning, especially when it follows the use of stool softeners and laxatives. It’s important to understand the potential causes and implications of your symptoms, as well as how to manage them effectively.

Firstly, the use of stool softeners like Sennosides and Magnesium Oxide can indeed lead to looser stools. These medications work by increasing the water content in the stool, making it easier to pass. However, if the dosage is too high or if your body is particularly sensitive to these medications, it can result in diarrhea. The fact that you are experiencing watery stools rather than formed ones suggests that the softeners may be contributing to your current condition.

In addition to the medications, your body is also adjusting post-surgery. After any surgical procedure, especially one involving the rectal area, it’s common for bowel habits to change temporarily. The digestive system can be sensitive after surgery, and factors such as anesthesia, changes in diet, and the stress of surgery can all contribute to altered bowel movements.
Regarding your concern about whether diarrhea could affect your surgical site, it is generally not ideal to have diarrhea after such a procedure. Frequent watery stools can lead to irritation around the anal area, which may complicate healing. It’s crucial to keep the area clean and dry to prevent any potential infections or complications.
To manage your symptoms, consider the following steps:
1. Adjust Medication Dosage: Consult your physician about reducing the dosage of your stool softeners. It may be beneficial to taper down to find a balance that allows for regular bowel movements without causing diarrhea.

2. Dietary Modifications: Focus on a bland diet that is gentle on your digestive system. Foods like bananas, rice, applesauce, and toast (the BRAT diet) can help firm up stools. Avoid high-fiber foods, dairy, and greasy or spicy foods until your bowel movements stabilize.

3. Hydration: Ensure you are drinking plenty of fluids, especially if you are experiencing diarrhea. However, avoid caffeinated and alcoholic beverages, as they can exacerbate dehydration.

4. Monitor Symptoms: Keep track of your bowel movements and any accompanying symptoms. If diarrhea persists for more than a couple of days or if you experience any additional symptoms such as fever, severe abdominal pain, or blood in your stool, seek medical attention promptly.

5. Follow-Up with Your Doctor: It’s essential to keep your healthcare provider informed about your symptoms. They may want to adjust your medications or investigate further if your diarrhea continues.

In summary, while diarrhea after a Modified Ferguson procedure can be influenced by the medications you are taking, it is also a common post-surgical occurrence. By adjusting your medication, modifying your diet, and staying hydrated, you can help manage your symptoms effectively. Always consult your healthcare provider for personalized advice and to ensure that your recovery is on track.

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