Managing Post-Surgery Pain and Bowel Movements After Hemorrhoid Surgery

Q: Managing Post-Surgery Pain and Bowel Movements After Hemorrhoid Surgery

Hello, in response to your questions： <br>1. <br>After hemorrhoid surgery, it is crucial to avoid constipation, as hard stools can cause pain at the surgical site. <br>If stool softeners are not effective, the dosage may need to be increased, but caution should be taken to avoid

Postoperative Bowel Movements After Hemorrhoid Surgery

Hello Dr.
Ke,
1.
It has been a week since my surgery, and for the past two to three days, having bowel movements has been very painful.
The hospital prescribed a mild laxative and stool softener, but it doesn't seem to be effective, as the stools are still hard.
The subsequent issue is that I can't seem to have a complete bowel movement; even when I manage to pass a little, the pain makes me lose the urge to go, resulting in multiple attempts each time, and each attempt is painful.
What should I do to resolve this issue? I'm really anxious every time I have to go because it hurts so much...
it feels like the wound might start bleeding again!
P.S.
The hospital prescribed one mild laxative/stool softener after each meal, along with medication to stop bleeding, pain relief medication, and a topical ointment to apply morning and night.
2.
Additionally, how long should I expect this pain to last? When can I stop using the gauze? The wound looks similar to my previous external hemorrhoids, and it seems like there are four lumps...
I hope these won't persist.
I have a keloid tendency; will this affect the healing of the wound?
I appreciate your help in answering these questions.
Thank you!

Niming, 20~29 year old female. Ask Date: 2010/04/23

Dr. Ke Fangxu reply Surgery

Hello, in response to your questions:
1.
After hemorrhoid surgery, it is crucial to avoid constipation, as hard stools can cause pain at the surgical site.
If stool softeners are not effective, the dosage may need to be increased, but caution should be taken to avoid causing diarrhea.
Additionally, some patients may hesitate to use the restroom due to fear of pain.
One method to consider is taking warm sitz baths, which the doctor will likely recommend post-surgery; this can help alleviate discomfort.
I often advise patients to urinate in the water, then change the water and soak again.
2.
Post-operative pain typically lasts for about a week.
After one week, there should only be mild discomfort, and complete pain relief usually occurs in about two weeks.
If there is no discharge from the wound, there is no need to apply a dressing.
However, I usually recommend placing a cotton ball at the anal area.
There may be some swelling at the surgical site, and many patients report that it feels the same as before the surgery.
The swelling should subside within a month, and the wound will appear smaller.
Personally, I have not encountered cases of keloid formation after anal surgery; if the wound heals properly, such complications should not occur.

Reply Date: 2010/04/23

More Info

Managing post-surgery pain and bowel movements after hemorrhoid surgery can be quite challenging, especially in the first few weeks following the procedure. It’s important to understand that pain during bowel movements is a common issue after hemorrhoid surgery, and there are several strategies to manage this discomfort effectively.

Firstly, it’s crucial to ensure that your bowel movements are as soft as possible to minimize pain. While you mentioned that the stool is hard despite taking the prescribed stool softeners, you might need to consider additional dietary changes. Increasing your fiber intake can significantly help in softening your stool. Foods rich in fiber include fruits (like apples, pears, and berries), vegetables (such as broccoli, carrots, and leafy greens), and whole grains (like oats, brown rice, and whole grain bread). Additionally, staying well-hydrated by drinking plenty of water throughout the day can aid in softening your stool.

If the current stool softeners are not effective, you might want to discuss with your physician the possibility of adjusting the dosage or trying a different type of laxative. Some patients find that a combination of stool softeners and mild laxatives can be more effective. Over-the-counter options like polyethylene glycol (MiraLAX) can also be considered, but it’s essential to consult your doctor before making any changes to your medication regimen.

Regarding the pain you experience during bowel movements, it’s important to manage this effectively to avoid developing a fear of bowel movements, which can lead to constipation. Applying a topical anesthetic cream, as prescribed by your doctor, can help numb the area and reduce pain during bowel movements. Additionally, taking a warm sitz bath before attempting to have a bowel movement can help relax the anal muscles and ease discomfort.

As for the duration of the pain, it varies from person to person. Typically, post-surgical pain should gradually decrease over the first few weeks. However, if you find that the pain is not improving or is worsening, it’s crucial to follow up with your healthcare provider. They can assess your healing process and determine if there are any complications, such as infection or excessive scarring.

Regarding your concern about the appearance of the surgical site and the possibility of keloid formation due to your predisposition, it’s essential to monitor the healing process closely. Keloids can occur in some individuals, but not everyone will experience this. If you notice excessive redness, swelling, or changes in the texture of the skin around the surgical site, it’s important to bring this to your doctor’s attention. They may recommend treatments to minimize scarring, such as silicone gel sheets or corticosteroid injections, if necessary.

In summary, managing post-surgery pain and bowel movements after hemorrhoid surgery involves a combination of dietary adjustments, proper medication management, and effective pain relief strategies. If you continue to experience significant pain or complications, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your comfort and recovery are paramount, and there are many resources available to help you through this process.

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