Concerns About Rectal Mass After Hemorrhoid Surgery: What to Know

Rectal mass issues?

Hello, Doctor.
My mother is 45 years old.
Recently, she has been experiencing discomfort due to internal and external hemorrhoids, so after discussing with her doctor, she decided to undergo surgery to have the hemorrhoids removed.
She just had the surgery five days ago.
However, after the procedure, the doctor informed me that he felt something unusual in her rectum during the surgery.
When I inquired further, the doctor mentioned that it was quite large and advised me not to tell my mother to avoid causing her anxiety.
He suggested waiting for about three weeks until the surgical wound heals before conducting a detailed examination.

I am very concerned.
During her follow-up visit two days ago, the doctor reiterated that we should wait for her wound to heal before performing any detailed checks, as doing so too soon could cause the wound to reopen.
In the days following the surgery, my mother frequently felt the urge to have a bowel movement, and she did pass stool, which was medium-sized and elongated.
There was some bright red bleeding during those bowel movements, and she has been experiencing abdominal bloating and discomfort, with a reduced appetite.
Even after eating, she often feels the need to use the restroom, and while the stool shape remains medium and elongated, there has been less bleeding recently.
Given her current condition, I would like to ask for your advice.
Is it better to wait until her wound heals a bit more before proceeding with the examination? Are there any dietary or other considerations we should be aware of? Currently, I have been preparing a light diet for her, primarily consisting of fish, white rice, steamed vegetables, tofu, bananas, tomatoes, and papaya.
Are there any issues with these food items, or should we make any improvements? Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2013/05/15

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello,
The next examinations I would recommend are a sigmoidoscopy or a colonoscopy to confirm the diagnosis.
Both procedures can indeed affect the healing of the surgical wounds from your recent operation, so I suggest waiting until the wounds have healed a bit more before proceeding with the tests.

In terms of diet, please pay attention to increasing your intake of fruits and vegetables, as well as staying hydrated.
It is important to avoid hard stools to prevent any disruption to the healing wounds.
There is nothing inappropriate about the dietary recommendations mentioned above.

Changhua Hospital cares about your health.

Dr.
Tsai An-shun

Reply Date: 2013/05/15

More Info

After undergoing hemorrhoid surgery, it is understandable to have concerns about any findings during the procedure, especially regarding the discovery of a mass in the rectal area. Your mother’s situation is understandably worrisome, and it’s important to approach this matter with care and attention.

First and foremost, it is common for surgeons to encounter unexpected findings during procedures. The fact that the surgeon has advised waiting for the surgical site to heal before conducting further examinations is a standard practice. This is primarily to avoid complications such as wound dehiscence (the reopening of the surgical wound) or increased pain and discomfort. Healing time can vary, but typically, it is advisable to wait at least two to three weeks post-surgery before performing any invasive diagnostic procedures.

Regarding your mother’s current symptoms, such as the urge to have bowel movements, abdominal discomfort, and the presence of fresh red blood during bowel movements, these can be common after rectal surgery. The surgical site may still be sensitive, and the healing process can lead to temporary changes in bowel habits. However, it is crucial to monitor these symptoms closely. If the bleeding persists, increases in volume, or is accompanied by severe pain, fever, or other concerning symptoms, it would be prudent to seek medical attention sooner rather than later.

In terms of diet, your approach to providing a light and nutritious diet is commendable. Foods that are high in fiber, such as fruits (like bananas and papayas), vegetables, and whole grains, can help promote regular bowel movements and prevent constipation, which is crucial after rectal surgery. However, it is essential to ensure that your mother stays well-hydrated, as adequate fluid intake is vital for digestive health and can help soften stools.

Here are some dietary considerations and recommendations:
1. Fiber Intake: Continue to include fiber-rich foods in her diet. Foods like oatmeal, whole grain bread, and legumes can be beneficial. However, introduce fiber gradually to avoid overwhelming her digestive system.

2. Hydration: Encourage her to drink plenty of fluids, particularly water. Staying hydrated is essential for preventing constipation and aiding in the healing process.

3. Avoid Irritants: It may be wise to avoid spicy foods, caffeine, and alcohol, as these can irritate the digestive tract and exacerbate discomfort.

4. Small, Frequent Meals: Instead of large meals, consider smaller, more frequent meals to ease digestion and reduce abdominal discomfort.

5. Monitor Symptoms: Keep a close eye on her symptoms. If she experiences significant changes in bowel habits, increased pain, or any new symptoms, consult her healthcare provider promptly.

6. Follow-Up Care: Ensure that she attends all follow-up appointments as scheduled. These visits are crucial for monitoring her recovery and addressing any concerns that may arise.

In summary, while it is essential to wait for the surgical site to heal before further investigations, maintaining a healthy diet and monitoring her symptoms closely are key steps in her recovery. If you have any further concerns or if her symptoms worsen, do not hesitate to reach out to her healthcare provider for guidance. Your proactive approach to her care is commendable, and it is vital to ensure she feels supported during her recovery process.

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