Postoperative care for hemorrhoid surgery?
Hello Dr.
Ke, I underwent a hemorrhoidectomy about nine days ago.
For the first four or five days, I experienced anal pain but was able to have bowel movements, approximately three times a day, feeling clean but in pain for a long time.
On the sixth day, after a bowel movement, I noticed two hemorrhoids appeared, which were somewhat painful and bright red.
I immediately returned to my doctor for treatment, and he performed a minor procedure to remove one of the hemorrhoids that had more bruising.
After returning home, I felt okay, but two days later, I went back for a follow-up.
However, yesterday, the wound bled continuously throughout the day, and in the afternoon, I had to undergo anesthesia again for electrocautery to stop the bleeding.
Is this serious? The pain inside the anal area has decreased after the surgery, but I currently have no appetite due to the wound still secreting blood and fluid.
There is also one external hemorrhoid that has not been addressed; what can I do about that?
Mr. Zeng, 30~39 year old female. Ask Date: 2016/01/31
Dr. Ke Fangxu reply Surgery
The disadvantage of circular hemorrhoid surgery is that the treatment effect for external hemorrhoids is relatively poor.
Therefore, some physicians may perform a minor excision specifically for the external hemorrhoids.
In your case, the bleeding from the excision site is a complication that can occasionally occur after surgery.
It is not a matter of severity; I recommend taking warm sitz baths and applying topical ointments.
As for whether to excise the remaining external hemorrhoid, that is a matter of personal judgment.
Reply Date: 2016/01/31
More Info
After undergoing a circumferential hemorrhoidectomy, it is not uncommon to experience a range of postoperative symptoms, including pain, bleeding, and the formation of new hemorrhoids. Your experience of pain in the first few days post-surgery is typical, as the surgical site is healing and the surrounding tissues are inflamed. The fact that you were able to have bowel movements, albeit with some discomfort, indicates that your recovery was initially progressing as expected.
However, the emergence of new hemorrhoids and subsequent bleeding after your bowel movements raises some concerns. The appearance of fresh, bright red blood can be alarming, but it is important to differentiate between normal postoperative bleeding and more serious complications. The fact that you had a small procedure to remove one of the new hemorrhoids suggests that your surgical team is actively monitoring your condition, which is a positive sign.
The bleeding you experienced after the small procedure and the need for cauterization with an electric needle indicates that your surgical site may still be quite sensitive and prone to bleeding. This can happen if the tissues are not fully healed or if there is excessive strain during bowel movements. It is crucial to manage your bowel habits carefully during this recovery phase. Straining can exacerbate bleeding and pain, so it is advisable to maintain a soft stool consistency through dietary adjustments, such as increasing fiber intake and staying well-hydrated.
Regarding your lack of appetite and the presence of blood-tinged discharge, these symptoms can be related to the ongoing healing process. Pain and discomfort can lead to a decreased desire to eat, which can further complicate recovery. It is essential to ensure you are getting adequate nutrition to support healing. If you find it difficult to eat solid foods, consider incorporating smoothies, soups, or other soft foods that are easier to digest.
As for the remaining external hemorrhoid that has not been addressed, it is important to communicate this to your healthcare provider. They may recommend further treatment options, which could include additional minor surgical intervention or conservative management strategies, such as topical treatments or lifestyle modifications.
In summary, while your symptoms are concerning, they are not uncommon following a circumferential hemorrhoidectomy. It is crucial to continue following up with your healthcare provider, especially if bleeding persists or worsens, or if you experience increased pain or other concerning symptoms. They can provide tailored advice and interventions to ensure your recovery proceeds smoothly. Remember to prioritize gentle bowel habits, maintain hydration and nutrition, and keep an open line of communication with your medical team regarding any changes in your condition.
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