Post-Hemorrhoid Surgery: Persistent Discomfort and Recovery

Postoperative Issues After Hemorrhoid Surgery

Dear Doctor,
It has been about two months since I underwent hemorrhoid surgery.
I no longer feel pain during bowel movements, and walking is normal; however, when sitting on a chair, I still feel a slight swelling around the anus, especially after having a bowel movement.

1.
Is this a sign that the internal wound in the anus has not fully healed? Will this sensation disappear over time?
2.
Or could it be that there are still internal hemorrhoids, causing the feeling of swelling due to congestion after a bowel movement?
Thank you,
Yifeng

Yi Feng, 30~39 year old female. Ask Date: 2013/11/07

Dr. Ke Fangxu reply Surgery

It has been two months since the surgery, so the wound should be completely healed and should not cause any swelling due to the wound itself.
However, since part of the internal hemorrhoidal tissue must be preserved during the surgery to prevent complications such as anal stenosis, this could be a contributing factor.
Even after undergoing hemorrhoidectomy, it is important to maintain good bowel habits and avoid prolonged sitting on the toilet to prevent any remaining internal hemorrhoidal tissue from worsening.

Reply Date: 2013/11/07

More Info

Post-hemorrhoid surgery recovery can be a complex process, and it's not uncommon for patients to experience lingering discomfort even weeks after the procedure. Based on your description, it seems you are experiencing some residual symptoms that can be attributed to a few factors.

1. Persistent Discomfort: The sensation of swelling or discomfort around the anal area, especially after bowel movements, can indeed be a sign that the surgical site is still healing. After hemorrhoid surgery, the tissues in the anal region can take time to fully recover. The healing process can vary significantly from person to person, depending on factors such as the extent of the surgery, individual healing capacity, and adherence to post-operative care instructions. It's not unusual for patients to feel some degree of discomfort or swelling for several weeks or even months after surgery. This sensation should gradually diminish as the tissues heal.

2. Possible Internal Hemorrhoids: Another possibility for the sensation of swelling could be the presence of residual internal hemorrhoids. Even after surgical intervention, if there were multiple hemorrhoids, some may not have been fully addressed during the procedure. When you have a bowel movement, the increased pressure can lead to engorgement of any remaining hemorrhoidal tissue, causing a feeling of swelling or fullness. If this is the case, it may be beneficial to discuss with your healthcare provider the possibility of further evaluation or treatment options.

Recommendations for Recovery
- Dietary Adjustments: Ensure that you are consuming a high-fiber diet to promote soft bowel movements. This can help minimize straining during defecation, which is crucial for healing. Adequate hydration is also essential.

- Post-operative Care: Follow any post-operative care instructions provided by your surgeon. This may include sitz baths, topical treatments, or medications to manage pain and promote healing.

- Monitoring Symptoms: Keep track of your symptoms. If you notice any significant changes, such as increased pain, bleeding, or changes in bowel habits, it’s important to contact your healthcare provider.

- Follow-Up Appointments: Attend any scheduled follow-up appointments with your surgeon. They can assess the healing process and determine if further intervention is necessary.

- Physical Activity: While you mentioned that walking is normal, ensure that you are not engaging in any activities that could strain the anal area. Gradually increase your activity level as tolerated.

When to Seek Medical Attention
If the sensation of swelling persists beyond a few months, or if you experience new symptoms such as severe pain, bleeding, or changes in bowel habits, it is important to consult with your healthcare provider. They may recommend further diagnostic evaluations, such as an anoscopy, to assess the condition of the anal canal and rectum.

In summary, while some discomfort after hemorrhoid surgery is normal, it’s essential to monitor your symptoms and maintain open communication with your healthcare provider to ensure a smooth recovery. With time and proper care, most patients see significant improvement in their symptoms.

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