Post-Surgery Complications: Managing Bacterial Infections After Hemorrhoid Surgery

Bacterial infection after hemorrhoid surgery?

Hello, Dr.
Ke.
In mid-June of this year, I underwent a complete excision of external and internal hemorrhoids using a self-paid ultrasound knife.
However, on the seventh day post-surgery, I experienced bleeding and had to go to the emergency room to manage the blood clot.
Since the surgery, I have been experiencing swelling at the surgical site and have been taking sitz baths 3-4 times daily, following the dietary instructions provided.
I have two questions for you:
1.
The area where the external hemorrhoid was located has become swollen around the anus, but the swelling is reducing slowly.
When can I expect the swelling to subside?
2.
After the surgery, there is a hard lump near the anus that is painful even with light pressure.
The surgeon mentioned that this pain could be due to a bacterial infection, and prescribed antibiotics for one week, which I completed as directed.
However, the symptoms have not improved.
Could this be an anal abscess? Does this indicate a surgical failure and the possibility of needing another surgery? How should I manage these symptoms?

A-Kai, 30~39 year old female. Ask Date: 2014/07/10

Dr. Ke Fangxu reply Surgery

1.
After hemorrhoid surgery, there will be a certain degree of swelling at the surgical site, which will subside as the wound heals.
This generally takes about 2 to 4 weeks.
Since you have undergone two surgeries, the swelling may last longer.

2.
If a bacterial infection has caused an anal abscess and oral antibiotics are ineffective, an incision and drainage procedure will be necessary.
If it is merely a wound infection, changing the type of antibiotic may suffice.
To determine whether it is an anal abscess or a simple wound infection, a physical examination is required.

Reply Date: 2014/07/10

More Info

Post-surgery complications, particularly after hemorrhoid surgery, can be concerning for patients. Your situation involves two main issues: persistent swelling around the surgical site and the presence of a painful hard lump, which may indicate a bacterial infection. Let’s address your questions and provide some additional context regarding post-operative care and potential complications.

1. Swelling Duration: After any surgical procedure, especially in sensitive areas like the anal region, swelling can be expected. The duration of swelling can vary significantly from person to person, depending on factors such as the extent of the surgery, individual healing rates, and adherence to post-operative care instructions. Generally, swelling may take anywhere from a few days to several weeks to resolve. In your case, since you are experiencing slow reduction in swelling, it is essential to continue with sitz baths, as they can help reduce swelling and promote healing. If the swelling persists beyond a few weeks or worsens, it is advisable to follow up with your surgeon for further evaluation.

2. Painful Hard Lump and Infection: The hard lump you are experiencing, especially if it is painful upon pressure, raises concerns about a possible infection, such as an anal abscess. Your surgeon's decision to prescribe antibiotics was appropriate, as bacterial infections can occur post-surgery. However, if you have completed the antibiotic course and still experience pain or the lump has not improved, further evaluation is necessary.
An anal abscess can develop when bacteria infect the tissue around the anal glands, leading to pus accumulation. Symptoms may include localized pain, swelling, redness, and sometimes fever. If an abscess is confirmed, it often requires surgical intervention to drain the pus and relieve pressure.
Next Steps: Given your symptoms, it is crucial to return to your healthcare provider for a thorough examination. They may perform imaging studies, such as an ultrasound, to assess the area for any abscess formation or other complications. If an abscess is present, timely drainage is essential to prevent further complications, such as the spread of infection or the development of chronic issues.

Post-operative Care: To manage and prevent infections after surgery, consider the following recommendations:
- Hygiene: Maintain good hygiene in the anal area. After bowel movements, gently clean the area with mild soap and water, and consider using moist wipes.

- Sitz Baths: Continue with sitz baths several times a day, especially after bowel movements, to soothe the area and promote blood flow, which aids healing.

- Diet: Ensure a high-fiber diet to prevent constipation, which can strain the surgical site and delay healing. Staying hydrated is also crucial.

- Monitoring Symptoms: Keep an eye on any changes in symptoms, such as increased pain, swelling, fever, or discharge. Report these to your healthcare provider promptly.

In conclusion, while post-surgical complications can be distressing, timely intervention and adherence to post-operative care can significantly improve outcomes. If you have ongoing concerns, do not hesitate to seek further medical advice. Your health and comfort are paramount, and addressing these issues early can help prevent more severe complications.

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