Post-Hemorrhoid Surgery Concerns: Swelling and Granulation Tissue

Postoperative issues after hemorrhoid surgery?

Dear Doctor,
I had a mixed hemorrhoid surgery a month and a half ago.

1.
I have been using the restroom daily, but I still feel swelling inside the anus after each bowel movement.
Is this a normal phenomenon?
2.
Previously, a small granulation tissue developed at the site of the external hemorrhoid wound, and it is now gradually growing larger and producing discharge.
Should I consider having it surgically removed?
Thank you,
Jun-Jie

Jun Jie, 30~39 year old female. Ask Date: 2013/10/28

Dr. Ke Fangxu reply Surgery

One and a half months after surgery for mixed hemorrhoids, the swelling should gradually decrease.
If discomfort and discharge persist, it may indicate that the wound has not yet healed, and it is advisable to return for a follow-up examination.
If necessary, suppositories can be used for treatment.
As for the granulation tissue that may develop at the wound site, it generally does not require special treatment; however, if the appearance is unacceptable, a repeat excision surgery can be performed.

Reply Date: 2013/10/28

More Info

After undergoing hemorrhoid surgery, it is not uncommon to experience some postoperative symptoms, including swelling and the formation of granulation tissue. Let's address your concerns one by one.

1. Postoperative Swelling: It is quite normal to feel some degree of swelling in the anal area after surgery, especially in the first few weeks. This swelling can be attributed to the surgical trauma and the body's natural healing response. However, if you are experiencing persistent swelling that lasts beyond six weeks, it may be worth discussing with your healthcare provider. Factors such as the extent of the surgery, individual healing rates, and any complications can influence recovery. If the swelling is accompanied by pain, increased redness, or discharge, it may indicate an infection or other complications that require medical attention.

2. Granulation Tissue: The appearance of granulation tissue is a common part of the healing process. Granulation tissue is a type of connective tissue that forms during wound healing and is characterized by its pink, bumpy appearance. It is generally a sign that the body is healing, but if you notice that the granulation tissue is growing larger and producing discharge, it may need to be evaluated. In some cases, excessive granulation tissue can lead to discomfort or complications, and your doctor may recommend removal if it becomes problematic.

Recommendations:
- Follow-Up Appointment: It is advisable to schedule a follow-up appointment with your surgeon or healthcare provider. They can assess the swelling and granulation tissue and determine if any intervention is necessary. They may perform a physical examination and possibly imaging studies if they suspect complications.

- Hygiene and Care: Maintain good hygiene in the anal area to prevent infections. Gentle cleaning with mild soap and water, along with warm sitz baths, can help soothe the area and promote healing.

- Avoid Straining: Ensure that you are not straining during bowel movements, as this can exacerbate swelling and discomfort. A high-fiber diet and adequate hydration can help facilitate easier bowel movements.

- Medication: If you are experiencing pain or discomfort, over-the-counter pain relief medications may be helpful. However, consult your doctor before taking any new medications, especially if you are on other treatments.

- Monitoring Symptoms: Keep an eye on any changes in your symptoms. If you experience increased pain, fever, or unusual discharge, seek medical attention promptly.

In conclusion, while some swelling and granulation tissue are normal after hemorrhoid surgery, persistent symptoms warrant further evaluation. Your healthcare provider can offer tailored advice and treatment options based on your specific situation. Remember, open communication with your medical team is key to a smooth recovery process.

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