Post-Surgery Concerns: Managing Rectal Pain and Bleeding After Surgery

Postoperative issues following rectal surgery?

Hello Doctor:
Cause: There is inflammation in a certain area of the rectum, leading to long-term rectal bleeding during bowel movements.
On November 3rd, a 1 cm inflamed area was excised and sutured.
It has been a week since the procedure, but I experience a feeling of heaviness in the anus accompanied by bleeding during bowel movements every morning.
The heaviness seems to cause difficulty in passing stool.
Since the stool is not hard, should I still take a stool softener? Can the heaviness and inability to pass stool cause bleeding from the rectum? When is it likely that the bleeding and pain will stop? Thank you, Doctor.

Kevin, 30~39 year old female. Ask Date: 2015/11/11

Dr. Ke Fangxu reply Surgery

I'm not sure if the inflammation you mentioned in the rectum is an anal abscess; if it is, the general management principle is incision and drainage without suturing.
However, if it is a general rectal inflammation, surgery is typically not indicated.
Therefore, you may need to confirm the exact issue with your attending physician.
Generally, after anal surgery, there may be mild bleeding for one to two weeks due to incomplete healing of the wound.
To prevent the wound from being affected by hard stools, doctors usually prescribe stool softeners.
Pain and bleeding typically resolve within two to four weeks.

Reply Date: 2015/11/11

More Info

Post-surgery concerns, especially regarding rectal pain and bleeding, can be quite distressing for patients. It is important to understand that some degree of discomfort and bleeding can be expected after surgery, particularly when it involves the rectal area. However, persistent or worsening symptoms should always be evaluated by a healthcare professional.

In your case, you mentioned that you underwent surgery to remove an inflamed area in the rectum, and now you are experiencing pain during bowel movements accompanied by bleeding. This can be attributed to several factors:
1. Postoperative Healing: After any surgical procedure, the body goes through a healing process. The tissues in the rectal area are sensitive and can take time to heal. It is not uncommon for patients to experience pain and some bleeding during bowel movements for a few weeks post-surgery.
2. Pain and Bowel Movements: The "dragging" pain you describe may be due to irritation of the surgical site or inflammation in the surrounding tissues. This discomfort can lead to anxiety about bowel movements, which may cause you to tense up, making it more difficult to pass stool. This tension can exacerbate pain and potentially lead to further bleeding.

3. Stool Consistency: Maintaining soft stools is crucial in preventing additional strain during bowel movements. Even if your stools are not hard, using a stool softener or a mild laxative can help ensure that your bowel movements are comfortable and less painful. If you are already experiencing pain, it is advisable to continue with stool softeners as they can help ease the passage of stool and reduce the risk of further irritation or injury to the surgical site.

4. Bleeding Concerns: Bleeding after surgery can be concerning, especially if it is persistent. While some bleeding can be normal, especially if the area is irritated, significant or increasing bleeding should prompt a visit to your healthcare provider. They may want to assess the surgical site to ensure there are no complications such as infection or a hematoma (a localized collection of blood outside of blood vessels).

5. When to Seek Help: If you notice that the bleeding is increasing, or if you experience severe pain that does not improve with over-the-counter pain relief, it is important to contact your surgeon or healthcare provider. They may want to perform an examination to rule out any complications.

6. Timeframe for Recovery: The timeframe for when you might expect to see an improvement in pain and bleeding can vary. Generally, after rectal surgery, patients may experience discomfort for several weeks. Most patients start to feel better within a few weeks, but complete healing can take longer. It is essential to follow up with your healthcare provider as scheduled to monitor your recovery.

In summary, while some pain and bleeding can be expected after rectal surgery, it is important to manage your symptoms effectively. Continue using stool softeners, practice relaxation techniques during bowel movements, and maintain open communication with your healthcare provider regarding your symptoms. If you have any concerns about the severity of your symptoms or if they worsen, do not hesitate to seek medical attention. Your recovery is a priority, and addressing these issues early can help ensure a smoother healing process.

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