Post-Hemorrhoid Surgery: Managing Bleeding and Recovery Concerns

Post-operative bleeding issues after hemorrhoid surgery?

Hello Doctor: It has been about 52 days since I underwent hemorrhoid surgery in mid-December last year.
Following the advice of my surgeon, I initially took stool softeners three times a day, gradually reducing it to once a day.
I have not taken any stool softeners for almost two weeks now.
Additionally, for the past month, I have been using a hemorrhoid suppository every night before bed to prevent post-operative stricture.
Excluding the first few weeks when there was bleeding from the surgical site, I had minimal bleeding after one month post-surgery.
However, in the past week, I have noticed a few drops of blood after passing gas, which initially was not concerning, but in the last 2-3 days, the bleeding has increased significantly.
It is no longer just a light pink color in the toilet; it has turned bright red.
1.
I would like to ask if this could be due to internal wounds that have not yet healed, or could it be a recurrence of hemorrhoids?
2.
I also noticed in the mirror that the shape of my anus does not resemble the typical appearance; instead, it seems to be surrounded by some slightly protruding tissue.
When I asked my surgeon about this, he mentioned that these slight swellings would gradually subside.
I would like to know if patients who have undergone hemorrhoid surgery eventually have their anus return to a normal shape like that of others?
3.
Lastly, could you please advise how long is generally recommended for a person to spend in the bathroom?
Thank you for your response!

Binghuan 4, 20~29 year old female. Ask Date: 2016/02/02

Dr. Ke Fangxu reply Surgery

1.
The surgical wound from hemorrhoid surgery will completely heal after one month.
Bleeding may occur due to excessive straining.
Hemorrhoid surgery does not completely remove all hemorrhoidal tissue, as this could lead to anal incontinence.
This is why excessive straining during bowel movements can cause bleeding, which is not a sign of recurrence.

2.
Yes, it can happen, but generally, it takes two to three months to six months for the scar tissue to stabilize before returning to normal.

3.
Of course, the shorter the better.
It is generally recommended to limit bathroom time to no more than ten minutes.
As long as you don't bring your phone or reading materials into the restroom, you will likely feel bored and want to leave after about five minutes.

Reply Date: 2016/02/02

More Info

Post-hemorrhoid surgery recovery can be a complex process, and it’s important to address your concerns regarding bleeding and the overall healing of the surgical site. Based on your description, it seems that you are experiencing some complications that warrant further discussion.

1. Bleeding After Surgery: The fresh bleeding you are experiencing, especially if it has increased in volume and is bright red, could indicate a few possibilities. It might be due to the internal wounds not healing properly, which can happen if there is excessive strain during bowel movements or if the tissue is still sensitive. It could also suggest a recurrence of hemorrhoids, especially if you have a history of them. It’s crucial to monitor the bleeding; if it continues or worsens, you should consult your surgeon or a gastroenterologist. They may recommend a physical examination or imaging studies to assess the healing process and rule out any complications.

2. Changes in Anal Shape: Post-surgery, it is not uncommon for the anal area to appear different due to swelling or the healing process. The "bumpy" appearance you describe could be a result of inflammation or the formation of scar tissue. Over time, many patients find that their anal shape returns to a more typical appearance as swelling subsides and healing progresses. However, this can vary from person to person. If the changes are concerning or if you experience discomfort, it’s advisable to follow up with your healthcare provider for a thorough evaluation.

3. Bowel Habits and Straining: After hemorrhoid surgery, it’s generally recommended to avoid straining during bowel movements, as this can lead to complications such as bleeding or recurrence of hemorrhoids. Ideally, you should spend no more than 5-10 minutes on the toilet. If you find yourself needing to push or strain, it may indicate that your stool is too hard or that you are not fully emptying your bowels. Continuing to use stool softeners, increasing your fiber intake, and staying hydrated can help facilitate smoother bowel movements. If you are still experiencing difficulties, consider discussing this with your healthcare provider, who may suggest additional dietary changes or medications.

In summary, while some bleeding can be expected post-surgery, significant changes in bleeding patterns or the appearance of the anal area should be evaluated by a medical professional. Regular follow-ups with your surgeon are essential to ensure proper healing and to address any complications early on. Additionally, maintaining healthy bowel habits is crucial for recovery and preventing future issues. If you have any further concerns or if symptoms persist, do not hesitate to seek medical advice.

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