Managing Post-Surgery Anal Fistula: Tips for Softening Stools and Healing

Q: Managing Post-Surgery Anal Fistula: Tips for Softening Stools and Healing

Hello： In response to your question, the healing speed of anal fistula wounds is generally slower than that of regular wounds. <br>If a complex anal fistula wound has not healed after more than a month, it is not considered abnormal. <br>The biggest concern after anal surgery is

After anal fistula surgery, the anus remains very narrow and the wound often reopens?

Hello, doctor: I apologize for bothering you again.
It has been over 40 days since my anal fistula surgery, and I still experience bleeding during bowel movements at times.
I visited the doctor yesterday, and he mentioned that my wound has not yet healed and that my stools are too hard.
The doctor said that my anal canal is narrower, which contributes to this issue.
He prescribed Normacol Plus for me to take, one packet every morning after breakfast, but my bowel movements are still hard.
I have started eating a vegetarian diet and drinking AB yogurt, but if my stools are still hard, what else can I do to soften them? Are there any other foods I should avoid besides fried foods and chili? Is it normal for an anal fistula like mine to heal so slowly?

fang, 20~29 year old female. Ask Date: 2010/05/14

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, the healing speed of anal fistula wounds is generally slower than that of regular wounds.
If a complex anal fistula wound has not healed after more than a month, it is not considered abnormal.
The biggest concern after anal surgery is constipation, as excessive straining can affect wound healing.
If one packet of Normacol does not resolve the issue, the recommended dosage for this medication is one packet in the morning and one in the evening; you might want to try this approach.
However, remember to drink plenty of water after taking it for better effectiveness.
If that still does not work, you may need to consider additional stool softeners.
Regarding diet, there are no specific restrictions aside from spicy foods, and it is essential to ensure adequate protein intake; otherwise, a lack of essential amino acids can lead to delayed wound healing.
Additionally, taking warm sitz baths can help keep the wound clean and promote healing.

Reply Date: 2010/05/14

More Info

Managing post-surgery anal fistula can be challenging, especially when it comes to ensuring that bowel movements are soft and the surgical site heals properly. Given your situation, where you are experiencing hard stools and some bleeding during bowel movements even 40 days post-surgery, it’s crucial to adopt a comprehensive approach to your diet and lifestyle to promote healing and comfort.

Dietary Recommendations
1. Increase Fiber Intake: Since you are already eating more plant-based foods, continue to focus on high-fiber options. Foods rich in fiber include:
- Fruits: Apples, pears, berries, bananas, and oranges.

- Vegetables: Broccoli, carrots, spinach, and sweet potatoes.

- Whole Grains: Oats, brown rice, quinoa, and whole-grain bread.

- Legumes: Beans, lentils, and chickpeas are excellent sources of fiber.

Aim for a daily fiber intake of about 25-30 grams. Gradually increase your fiber intake to avoid gas and bloating.

2. Hydration: Drink plenty of water throughout the day. Adequate hydration is essential for softening stools. Aim for at least 8-10 glasses of water daily. Herbal teas and clear broths can also contribute to your fluid intake.

3. Probiotics: Since you are consuming yogurt, ensure it contains live cultures, which can help maintain gut health. You might also consider other probiotic-rich foods like kefir, sauerkraut, kimchi, or taking a probiotic supplement.

4. Healthy Fats: Incorporate healthy fats into your diet, such as avocados, nuts, seeds, and olive oil. These can help lubricate the intestines and ease bowel movements.

5. Avoid Constipating Foods: In addition to avoiding fried and spicy foods, limit your intake of:
- Processed foods (which often lack fiber)
- Dairy products (if they cause constipation for you)
- Red meat (which can be harder to digest)

Lifestyle Modifications
1. Regular Exercise: Engage in light physical activity, such as walking or yoga, which can stimulate bowel movements and improve overall digestive health.

2. Scheduled Bathroom Time: Try to establish a routine for bowel movements. Allow yourself enough time in the bathroom without rushing, which can help reduce strain.

3. Use of Stool Softeners: If Normacol Plus is not sufficient, discuss with your doctor the possibility of adding other stool softeners or laxatives to your regimen. Options like docusate sodium or polyethylene glycol can be effective.

4. Warm Baths: Taking warm sitz baths can help soothe the area and promote relaxation, which may make bowel movements easier.

Healing Process
It’s not uncommon for anal fistula surgeries to take time to heal, especially if the area is narrow or if there are complications. Healing can vary significantly from person to person. If you continue to experience issues with bleeding or pain, or if your symptoms worsen, it’s essential to follow up with your healthcare provider. They may need to assess the surgical site for any complications or consider additional treatments.

Conclusion
In summary, focus on a high-fiber diet, stay well-hydrated, and incorporate healthy fats while avoiding constipating foods. Regular exercise and proper bathroom habits can also aid in managing your symptoms. If your current regimen is not effective, consult your physician for further evaluation and potential adjustments to your treatment plan. Healing from anal fistula surgery can be a gradual process, and it’s important to be patient and proactive in your recovery.

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