Post-Surgery Constipation After Hemorrhoidectomy: What to Expect

Post-operative bowel movements after hemorrhoid surgery can be very challenging?

I would like to ask the doctor, I have undergone a hemorrhoidectomy for both internal and external hemorrhoids.
The doctor mentioned that my condition was severe and sutured in three places, and also recommended some out-of-pocket supplies.
On the first and second days post-surgery, I did not experience pain, but starting on the third day, I felt the urge to have a bowel movement but was unable to do so, which caused pain.
Now, on the fifth day, I still cannot have a bowel movement, and I haven't been able to since the surgery.
Is this normal? I feel like the sutured area is tearing when I try to push.
Are there any ways to alleviate this discomfort?

Ruby, 20~29 year old female. Ask Date: 2015/07/07

Dr. Xu Kaixi reply Surgery

According to your letter, you have a more severe case of internal and external hemorrhoids and have undergone excision surgery (with three sutured areas).
Due to the larger wound area, experiencing pain in the days following the surgery is normal.
You may be hesitant to exert yourself during bowel movements due to the pain, and straining during bowel movements could potentially cause the wound to reopen.
These are common conditions that may occur during the recovery process.
You can use medications such as pain relievers or stool softeners to alleviate symptoms and discomfort during recovery.
It is recommended that you return for a follow-up examination.

Reply Date: 2015/07/07

More Info

Post-surgery constipation, especially after a hemorrhoidectomy, is a common issue that many patients face. It can be particularly distressing, especially when combined with the discomfort and pain that often accompany recovery from such a procedure. Here’s what you can expect and some strategies to alleviate the situation.

Understanding Post-Surgery Constipation:
After a hemorrhoidectomy, the body undergoes significant stress, and the surgical site can be sensitive and painful. The pain can lead to a natural reluctance to have a bowel movement, which can exacerbate constipation. Additionally, medications often prescribed post-surgery, such as opioids for pain management, can further contribute to constipation. The combination of these factors can create a challenging situation for patients.

Is It Normal?
It is not uncommon for patients to experience constipation for several days following a hemorrhoidectomy. The first few days post-surgery may be relatively pain-free, but as the anesthesia wears off and the body begins to heal, discomfort can increase, particularly in the anal area. If you are feeling the urge to have a bowel movement but are unable to do so, it can be frustrating and concerning. The sensation of pressure or the feeling that the stitches might be tearing can be alarming but is often a normal part of the healing process.

What Can You Do?
1. Hydration: Ensure you are drinking plenty of fluids. Staying well-hydrated can help soften the stool, making it easier to pass.

2. Dietary Adjustments: Incorporate high-fiber foods into your diet, such as fruits, vegetables, whole grains, and legumes. Fiber can help bulk up the stool and promote regular bowel movements.

3. Stool Softeners: Over-the-counter stool softeners, such as docusate sodium, can be beneficial. These medications help to soften the stool, making it easier to pass without straining.

4. Gentle Laxatives: If dietary changes and stool softeners do not provide relief, you may consider using a gentle laxative. However, it’s essential to consult your physician before starting any new medication.

5. Warm Baths: Taking warm baths can help relax the anal muscles and may provide some relief from discomfort. This can also promote relaxation and reduce anxiety about bowel movements.

6. Avoid Straining: It’s crucial to avoid straining during bowel movements, as this can exacerbate pain and potentially disrupt the surgical site. If you feel the urge to go, try to relax and give yourself time.

7. Consult Your Doctor: If you have not had a bowel movement after five days, it is advisable to contact your healthcare provider. They may recommend additional treatments or interventions to help relieve your constipation.

When to Seek Help:
If you experience severe pain, bleeding, or any signs of infection (such as fever or increased swelling), it’s essential to seek medical attention promptly. Your doctor can provide guidance tailored to your specific situation and may need to evaluate your surgical site to ensure proper healing.

In summary, while post-surgery constipation after a hemorrhoidectomy is common, there are several strategies you can employ to alleviate the discomfort. Maintaining hydration, adjusting your diet, and using stool softeners can be effective. However, if symptoms persist or worsen, do not hesitate to reach out to your healthcare provider for further assistance. Your recovery is important, and addressing these concerns early can help ensure a smoother healing process.

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