Post-Hemorrhoid Surgery: Why Am I Still Experiencing Bleeding?

Two months after hemorrhoid surgery, there is still blood when wiping?

Hello, I would like to ask if a patient has experienced bleeding during bowel movements two months after hemorrhoid surgery, could this indicate that internal hemorrhoids have reoccurred, or could there be another reason? If this situation persists, will the hemorrhoids return immediately? Thank you.

Xiao Xiao, 20~29 year old female. Ask Date: 2024/07/26

Dr. Zhang Shuhao reply Surgery

If the wound from hemorrhoid surgery has not yet healed, there may be bleeding during bowel movements due to friction and straining, which will gradually improve as the wound heals.
If hemorrhoids are surgically removed, they are unlikely to recur in a short period.
If there are any concerns, a follow-up examination at the original surgical site can be conducted for assessment.

Reply Date: 2024/07/26

More Info

After hemorrhoid surgery, experiencing occasional bleeding during bowel movements can be concerning and may indicate several possible issues. It's important to understand the underlying reasons for this bleeding and what steps can be taken to address it.

Firstly, it's essential to recognize that hemorrhoid surgery, whether it's a hemorrhoidectomy or a less invasive procedure like rubber band ligation, can lead to some residual bleeding as the surgical site heals. The healing process can take several weeks to months, and during this time, it is not uncommon for patients to notice some blood in their stool or on toilet paper, especially if they are straining during bowel movements.

There are a few potential reasons for the bleeding you are experiencing:
1. Incomplete Healing: If the surgical site has not fully healed, it can lead to intermittent bleeding. This is particularly true if there is any irritation or trauma to the area during bowel movements.

2. New Hemorrhoids: It is possible to develop new hemorrhoids after surgery, especially if there are ongoing risk factors such as constipation, straining, or prolonged sitting on the toilet. If you have a history of hemorrhoids, the risk of recurrence remains, particularly if lifestyle changes are not implemented.

3. Anal Fissures: Sometimes, the trauma of passing a hard stool can cause anal fissures, which are small tears in the lining of the anus. These can be quite painful and may cause bleeding during bowel movements.

4. Infection or Complications: Although less common, infections or other complications from the surgery can lead to bleeding. If you notice increased pain, swelling, or discharge, it is crucial to consult your healthcare provider.

To manage and potentially reduce the risk of further bleeding or the recurrence of hemorrhoids, consider the following recommendations:
- Dietary Changes: Ensure you are consuming a high-fiber diet to promote soft stools and reduce straining. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated can help.

- Stool Softeners: If you are experiencing constipation, over-the-counter stool softeners can be beneficial. They can help make bowel movements easier and less painful.

- Avoid Straining: Try to avoid straining during bowel movements. If you feel the urge to go, do so promptly rather than waiting, as this can lead to harder stools.

- Warm Baths: Soaking in warm baths can help soothe the area and promote healing. This practice can also relieve discomfort associated with hemorrhoids.

- Follow-Up with Your Doctor: If the bleeding persists or worsens, it is essential to follow up with your healthcare provider. They may perform an examination to determine the cause of the bleeding and recommend appropriate treatment.

In summary, while some bleeding after hemorrhoid surgery can be normal, persistent or significant bleeding should not be ignored. It is crucial to monitor your symptoms and consult with your healthcare provider to rule out any complications and to discuss further management options. Taking proactive steps in your diet and lifestyle can significantly impact your recovery and help prevent the recurrence of hemorrhoids.

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