Post-External Hemorrhoid Surgery: Pain and Complications

Q: Post-External Hemorrhoid Surgery: Pain and Complications

Hello： In response to your question, it is common to experience wound bleeding, pain, and abnormal sensations within a week after hemorrhoid surgery. <br>As long as there is no significant bleeding or passage of blood clots, there is usually no cause for concern. <br>However, the

What are the issues after external hemorrhoid surgery?

I underwent external hemorrhoid surgery on April 22 and initially thought my recovery was going well.
However, on the third day after resuming my normal diet, I began experiencing severe discomfort.
After my first bowel movement, I felt a constant urge to defecate at the anal area.
Each time I went to the bathroom, I had a bowel movement, and even passing gas would lead to unintentional defecation.
Unlike typical diarrhea, my stools were soft but not watery.
Each bowel movement caused increasing pain at the surgical site, and this continued for two days.
By April 26, I noticed blood in my stool (the toilet water was also bloody).
I was very worried, and with two days left until my follow-up appointment, I was in significant discomfort.
I sought help from a gastroenterology clinic, which managed to alleviate the persistent urge to defecate.
My question is: is this situation normal after such surgery? What could be causing the sensation of urgency at the anus? Could there have been an issue during the surgery? I also called the hospital to ask a doctor, but they always said it was normal.
However, I remain concerned that the doctor might be withholding information.

Wenwen, 20~29 year old female. Ask Date: 2005/04/27

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, it is common to experience wound bleeding, pain, and abnormal sensations within a week after hemorrhoid surgery.
As long as there is no significant bleeding or passage of blood clots, there is usually no cause for concern.
However, the abnormal sensations can be more troubling; most people feel an urge to have a bowel movement frequently throughout the day, which can lead to bleeding from the surgical site.
The cause of these abnormal sensations is due to the incision made in the anal skin.
It is generally recommended to take warm sitz baths, and normal sensations should return within 1 to 2 weeks.

Reply Date: 2005/04/27

More Info

Post-external hemorrhoid surgery, it is not uncommon for patients to experience a range of symptoms, including pain, discomfort, and changes in bowel habits. Your experience of persistent urges to defecate, accompanied by pain and the presence of blood in your stool, raises valid concerns that warrant further discussion.

Firstly, it is important to understand that after hemorrhoid surgery, the surgical site is healing, and the surrounding tissues can be sensitive. The sensation of needing to have a bowel movement, even when there is little to pass, can be attributed to several factors:
1. Surgical Trauma: The surgery itself can cause inflammation and irritation in the anal area. This can lead to heightened sensitivity, making you feel as though you need to have a bowel movement even when your bowel is not full.

2. Nerve Sensitivity: The anal region is rich in nerve endings. Post-surgery, these nerves may become hyperactive or overly sensitive, leading to a persistent urge to defecate.

3. Bowel Movement Changes: After surgery, your bowel habits may change due to dietary adjustments, pain medications, or anxiety about bowel movements. Soft stools can sometimes lead to a feeling of incomplete evacuation, which can exacerbate the sensation of needing to go.

4. Constipation and Straining: If you are experiencing pain during bowel movements, you may unconsciously be avoiding full evacuation, leading to constipation. This can create a cycle where the urge to go becomes more pronounced, and straining can further irritate the surgical site.

The presence of blood in your stool is concerning and should not be overlooked. While some bleeding can occur after hemorrhoid surgery, especially if there is straining or if the stool is hard, significant bleeding or blood in the toilet water should be evaluated by a healthcare professional. It is essential to ensure that there are no complications such as:
- Infection: Surgical sites can become infected, leading to increased pain and bleeding.

- Suture Issues: Sometimes, the sutures used during surgery can cause irritation or may not dissolve as expected, leading to discomfort and bleeding.

- Recurrent Hemorrhoids: In some cases, if the underlying issues that led to hemorrhoids were not fully addressed, they may recur.

Given your symptoms, it is advisable to follow up with your surgeon or a gastroenterologist sooner rather than later. They can perform a thorough examination to rule out any complications and provide you with appropriate management strategies. In the meantime, consider the following tips to help manage your symptoms:
- Dietary Adjustments: Ensure you are consuming a high-fiber diet to promote soft stools and regular bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying hydrated is also crucial.

- Pain Management: Over-the-counter pain relievers may help alleviate discomfort. However, consult your doctor before taking any medication.

- Warm Sitz Baths: Soaking in warm water can help soothe the anal area and promote healing.

- Avoid Straining: When you feel the urge to go, try to relax and avoid straining, as this can worsen pain and lead to further complications.

In summary, while some discomfort and changes in bowel habits can be expected after external hemorrhoid surgery, the severity of your symptoms, particularly the presence of blood, should be addressed promptly. Do not hesitate to seek medical advice to ensure a smooth recovery and to alleviate your concerns.

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