Post-Hemorrhoid Surgery: Common Concerns and Dietary Guidance

Q: Post-Hemorrhoid Surgery: Common Concerns and Dietary Guidance

Question 1： Anal stenosis refers to a narrowing of the anal canal compared to its pre-surgical ability to dilate. <br>If anal stenosis occurs after hemorrhoid surgery, it generally recovers elasticity and width gradually over several months, depending on the severity of the hemor

Postoperative Issues Related to Hemorrhoid Surgery

Hello, Dr.
Hsu.
I have reviewed the information on the forum and have also researched a lot of information online.
I would like to ask some questions regarding post-operative care for internal and external hemorrhoid surgery.

I underwent hemorrhoid surgery on January 28.
For the first seven days, I experienced significant difficulty and 100% pain during bowel movements.
After 15 days, the pain decreased to about 50-80%, and after 30 days, it reduced to 5-10%.
On February 6, due to insufficient water intake and pain from the surgery, I developed a fever, headache, and abdominal pain.
On February 8, I visited the emergency department, where I was diagnosed with a urinary tract infection.
The doctor was concerned about potential kidney inflammation, so I was hospitalized for four days to receive antibiotics.

On March 5, I experienced severe constipation, as I had not had a bowel movement for three days prior.
I felt a strong urge to defecate, but it was very difficult to pass stool, leading to significant discomfort.
I could only alleviate the pain through pelvic floor exercises and sitz baths.
After an emergency enema, I was finally able to pass stool, but the pain in my anus persisted.
I could only return home to continue sitz baths for relief.
Question 1: What is the definition of anal stenosis? I understand that the anal tissue takes about six months to fully heal and regain elasticity after surgery.
Given that I had severe internal and external hemorrhoids classified as grade IV, I have experienced difficulty in bowel movements one month post-surgery.
My anal dilation is approximately 1 cm.
Should I rely on stool softeners for the first three to six months to maintain comfortable bowel movements until the anal tissue regains its elasticity? Otherwise, I risk severe complications, such as anal fissures, if I experience constipation again.
I am very concerned about the possibility of needing another surgery for anal stenosis, as well as the impact of these issues on my ability to work.
Question 2: Regarding dietary issues, many people believe that probiotics like yogurt can enhance gastrointestinal motility, but aren’t dairy products and eggs known to cause gas? Is yogurt beneficial or detrimental for constipation? Sweet potatoes have similar effects but can also cause gas, right? This has led me to question whether my post-operative constipation is due to dietary issues or anal stenosis.
I believe many hemorrhoid patients share this concern about whether their bowel problems stem from dietary choices or anal narrowing.
I kindly request your detailed response to the above questions.
I truly hope to avoid further pain and complications, and I hope other users can also gain a clear understanding of the necessary care and dietary considerations.
Thank you.

Guo Xiansheng, 30~39 year old female. Ask Date: 2016/03/06

Dr. Xu Kaixi reply Surgery

Question 1: Anal stenosis refers to a narrowing of the anal canal compared to its pre-surgical ability to dilate.
If anal stenosis occurs after hemorrhoid surgery, it generally recovers elasticity and width gradually over several months, depending on the severity of the hemorrhoids.
During the recovery phase, as you mentioned, it is advisable to use stool softeners or other medications that aid in bowel movements.
Question 2: Regarding dietary issues, as long as consumption is moderate and not excessive, yogurt or probiotics, along with other high-fiber foods, are beneficial for gastrointestinal health and bowel movements, unless there is a specific condition that causes an allergic reaction to these foods, in which case they would not be suitable.

Reply Date: 2016/03/06

More Info

Post-hemorrhoid surgery, many patients experience a range of concerns, particularly regarding dietary habits and bowel movements. Your experience is not uncommon, and it’s essential to address both the physical and dietary aspects to facilitate recovery and prevent complications.

Understanding Anal Stenosis and Recovery
Anal Stenosis: This condition refers to a narrowing of the anal canal, which can occur post-surgery due to scarring or inflammation. It can lead to significant discomfort and difficulty during bowel movements. The healing process for the anal tissue can take several months, and it’s crucial to allow adequate time for recovery. Generally, it can take up to six months for the anal tissue to regain its elasticity and function properly.

Dietary Management: Given your situation, it’s advisable to focus on maintaining soft stools to ease the passage of bowel movements. Softening agents, such as stool softeners or fiber supplements, can be beneficial during the initial recovery phase. Incorporating a high-fiber diet is essential, but it should be balanced with adequate hydration to prevent gas and bloating, which can exacerbate discomfort.

Dietary Recommendations
1. Hydration: Ensure you are drinking plenty of water. Dehydration can lead to harder stools, making bowel movements painful and difficult. Aim for at least 8-10 glasses of water a day.

2. Fiber-Rich Foods: Include foods high in fiber such as fruits (like apples and pears), vegetables (like broccoli and carrots), and whole grains (like oats and brown rice). These help to bulk up the stool and promote regular bowel movements.

3. Probiotics: While dairy products can cause bloating in some individuals, probiotics found in yogurt or supplements can help balance gut flora and improve digestion. If dairy causes discomfort, consider lactose-free options or non-dairy probiotic sources.

4. Avoid Gas-Producing Foods: Foods like beans, lentils, and certain cruciferous vegetables (like cabbage and cauliflower) can cause gas. Monitor your body’s response to these foods and adjust your intake accordingly.

5. Gradual Introduction of Foods: If you’re concerned about certain foods causing bloating, introduce them gradually into your diet to see how your body reacts.

Monitoring and Follow-Up
Given your ongoing symptoms, it’s crucial to maintain regular follow-ups with your healthcare provider. If you continue to experience severe pain, difficulty with bowel movements, or signs of infection (such as fever or increased pain), seek medical attention promptly. It may be necessary to evaluate for anal stenosis or other complications that could require intervention.

Conclusion
In summary, managing your diet post-hemorrhoid surgery is vital for recovery. Focus on hydration, a fiber-rich diet, and monitoring your body’s responses to different foods. If symptoms persist or worsen, do not hesitate to consult your healthcare provider for further evaluation and management. Your recovery is paramount, and understanding the interplay between your diet and bowel health will help you navigate this challenging period more effectively.

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