Post-Surgery Discomfort: Recovery After Hemorrhoid and Fissure Surgery

More than four months post-surgery?

Hello Doctor,
I underwent minimally invasive surgery for anal fissures and hemorrhoids over four months ago, and I am still experiencing discomfort.
This week, the symptoms have become more pronounced.
The discomfort feels like a sharp pain or irritation, especially after showering when I use a fan to dry off, and when lying down at night.
I have not noticed any bleeding during bowel movements.
During my last follow-up appointment, I mentioned this discomfort to my doctor.
After a brief examination of the external anal area, the doctor asked if the pain I was experiencing now was significantly less than right after the surgery.
The doctor concluded that everything looked fine externally and that the pain had decreased, suggesting that I might be overly sensitive.
I was advised to return for a prescription for a stool softener.

Perhaps I am not articulating my discomfort well, which is why there was no further examination.
However, this discomfort has been bothering me for some time, and coupled with recent stress from work-related issues, my anxiety has increased.
I would like to ask if you recommend that I seek a second opinion from another doctor at this time.
Is there still a possibility of infection after four months? If I want to alleviate this discomfort, can I use a topical ointment like Yizhi Kang? I found online that this ointment does not contain steroids and should not affect skin issues.
Do you have any other recommendations for hemorrhoid ointments? If the wound has not fully healed, will using hemorrhoid ointment affect the healing process? Is this discomfort due to the wound not healing or possibly from scar tissue rubbing against something? I find it curious that the discomfort is more pronounced when lying down.

I apologize for the many questions, and I greatly appreciate your time in answering them.
Thank you.

Yi, 20~29 year old female. Ask Date: 2024/03/22

Dr. Zhang Shuhao reply Surgery

1.
You can gently touch the area while applying medication or during a sitz bath to distinguish between pain from the skin at the wound site and deeper pain from the contraction of the levator ani muscle.
It is advisable to discuss your concerns in detail with the original surgeon, and if the issues remain unresolved, consider consulting another physician.
2.
After more than four months, it is unlikely that the issue is due to an infection.
Medications like Yizhi Kang ointment or other hemorrhoid creams can help relieve pain, but it is not recommended to apply them directly to an unhealed wound.
3.
The need for a pelvic examination may be due to the wound not yet healing or scar tissue formation.
It is recommended to return for a follow-up examination to identify the problem.

Reply Date: 2024/03/22

More Info

Post-surgery discomfort following hemorrhoid and fissure surgery can be a common experience, and it’s understandable that you are feeling concerned about your ongoing symptoms four months after the procedure. Let’s break down your situation and address your questions.

Firstly, it’s important to recognize that recovery from anal surgeries, including hemorrhoidectomy and fissure repair, can vary significantly from person to person. While many patients may experience a gradual reduction in pain and discomfort, others may continue to feel discomfort for an extended period, particularly if there are underlying factors contributing to their symptoms.

The discomfort you are describing—sharp pain or a sensation of friction, especially after bathing or while lying down—could be attributed to several factors. One possibility is that the surgical site is still healing, and any irritation or friction can exacerbate your discomfort. Scar tissue formation is another consideration; as the tissue heals, it can become sensitive, and the presence of scar tissue may lead to sensations of tightness or discomfort, particularly when pressure is applied or during certain movements.

Regarding your concern about infection, while it is less likely four months post-surgery, it is not impossible. Signs of infection may include increased redness, swelling, warmth, or discharge from the surgical site. If you notice any of these symptoms, it would be prudent to consult your healthcare provider.

As for the use of topical treatments like the medication you mentioned (益痔康), it is generally advisable to consult with your doctor before applying any new products to the surgical area. While the product may not contain steroids and is marketed as safe, it’s essential to ensure that it won’t interfere with your healing process. Your doctor can provide guidance on whether it’s appropriate for your situation.

If you feel that your discomfort is significant and affecting your quality of life, seeking a second opinion could be beneficial. A different perspective may provide you with additional insights or treatment options that could help alleviate your symptoms. It’s crucial to communicate your concerns clearly to any healthcare provider, as this will help them understand the severity and nature of your discomfort.

Stress can also play a significant role in how we perceive pain. If you are experiencing increased stress from work or personal issues, it may heighten your sensitivity to discomfort. Engaging in stress-reducing activities, such as mindfulness, yoga, or gentle exercise, may help improve your overall well-being and potentially reduce your perception of pain.

In summary, while some discomfort can be expected after hemorrhoid and fissure surgery, persistent or worsening symptoms warrant further evaluation. It’s advisable to consult with your healthcare provider about your ongoing discomfort, the potential for scar tissue sensitivity, and the appropriateness of any topical treatments. Additionally, managing stress and seeking support can be beneficial in your recovery journey. Remember, open communication with your healthcare team is key to ensuring a smooth recovery process.

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