Post-Surgery Concerns: Fever and Diarrhea After Fistula Surgery

Post-fistula surgery

Hello Doctor, I underwent anal fistula surgery on March 14.
During my follow-up appointment on March 22, it was confirmed that the external wound was healing well.
However, starting from the night of March 23, I developed a fever of about 38.7°C and began experiencing diarrhea.
I took pain medication, but it did not reduce the fever.
I assess that there is currently no redness, swelling, heat, or pain at the external wound, but I am concerned about the possibility of a postoperative infection.
Additionally, if the diarrhea is caused by a common rotavirus or norovirus, could this lead to secondary issues with the internal wound of the fistula? Thank you.

Ning Ba, 40~49 year old female. Ask Date: 2024/03/24

Dr. Zhang Shuhao reply Surgery

After anal fistula surgery, if the wound is in an open state, the risk of infection is low.
Pain associated with anal inflammation and abscess is usually quite pronounced.
If there are symptoms such as fever and diarrhea, along with cold-like symptoms, it may indicate a viral infection.
In this case, diarrhea can irritate the wound, but as long as you take warm sitz baths and keep the wound clean, it should not significantly affect the healing process.

Reply Date: 2024/03/24

More Info

Post-surgery complications such as fever and diarrhea can be concerning, especially after a procedure like fistula surgery. It’s crucial to understand the potential causes and implications of these symptoms in the context of your recent surgery.

Firstly, fever after surgery can be attributed to several factors. The most common cause is an infection, which can occur at the surgical site or systemically. Even if the external wound appears to be healing well without signs of redness, swelling, or increased pain, it is still possible to have an internal infection. Surgical procedures can introduce bacteria into the body, and the immune response can manifest as fever.
In your case, the fever of 38.7°C (101.7°F) starting a few days post-surgery raises the suspicion of a possible infection. It is essential to monitor other symptoms that may accompany the fever, such as chills, increased heart rate, or any unusual discharge from the surgical site. If these symptoms are present, it is advisable to contact your healthcare provider immediately for further evaluation.

Diarrhea can also occur post-surgery for various reasons. It could be a reaction to medications, particularly antibiotics, which are often prescribed to prevent infections after surgery. Antibiotics can disrupt the normal gut flora, leading to diarrhea. Additionally, if you have contracted a viral infection, such as rotavirus or norovirus, this could also explain the gastrointestinal symptoms.
Regarding your concern about whether diarrhea could affect the internal wound from the fistula surgery, it is important to note that while diarrhea itself may not directly harm the surgical site, it can lead to complications. Frequent bowel movements can cause irritation around the anal area, potentially impacting the healing process of the fistula. Moreover, if the diarrhea is due to an infectious agent, it could pose a risk of spreading the infection to the surgical site.

In managing your symptoms, it is crucial to stay hydrated, especially if you are experiencing diarrhea. Oral rehydration solutions can help replenish lost fluids and electrolytes. However, you should avoid self-medicating without consulting your doctor, as some medications can worsen diarrhea or mask underlying issues.

Given your symptoms, it is highly recommended to return to your healthcare provider for a thorough evaluation. They may perform blood tests, stool tests, or imaging studies to determine the cause of your fever and diarrhea. If an infection is confirmed, appropriate treatment, such as antibiotics, may be necessary.

In summary, while fever and diarrhea can be common post-surgical symptoms, they warrant careful monitoring and prompt medical attention to rule out any serious complications. Always communicate openly with your healthcare provider about any new or worsening symptoms following surgery to ensure the best possible recovery.

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