Hemorrhoids

Hemorrhoids after surgery: possible complications and treatment methods

Registered: 2015-04-04
Posts: 51

Good day! history of torment. a week ago they removed an enormous fringe on an outpatient surgitron and excised a chronic fissure with a large tubercle (no sutures were made) - this removed the effects of non-healing after the first operation. the first operation was 8 months ago - three external nodes were removed (these are old problems and complications of unsuccessful ligation 10.5 months ago), after which a huge fringe formed from one wound, and from the second a chronic fissure with a tubercle. the operation was now done by another doctor, not the first. the first one said after the operation to immediately make candles and smear everything inside. Now the second doctor forbids after the operation the candles and smear inside, says you can’t injure your wounds with your finger and candles. only treat with chlorhexidine and 5 times a day on top of the dressing with levomikol, if there is a spasm, levomikol with 0.4 nitroglycerin ointment said.
Tell me, please (after the operation, 8 days have passed, blood, pain, cramping). and today, the doctor has slightly cut the edge of the postoperative wound:
1 I do not understand as a result of touching inside or not? smear with a finger? to put in candles? or not injure, as the doctor says.
2 how to deal with spasm (after morning defecation), from which, of course, wild pain? the doctor did not prescribe a bath. Yes, I am afraid of them increased edema, from which the fringe appears.
3 which is stronger and better from spasm - a nitroglycerin ointment prepared in a pharmacy or home-made nifedipine ointment (tablets + levomycol + lidocaine)? smear them outside or inside too? the doctor again spoke from the outside.
4 if nitroglycerin is better than 0.2 or 0.4?
5 nitroglycerin pharmacy smeared on the outside, added to the bandage with levomikole. it didn’t help much, only the roof, of course, more.
6 do papaverine suppress sphincter spasms? Although the doctor forbade healing candles, she asked for papaverine suppositories when asked how else to remove the spasm. weird. once tried - did not like.
7 after the operation, is it necessary to lie at home or can one live a normal life, walk, ride, sit? the doctor says you can. but I read that many already a month on sick leave. how to live, so as not to harm?
8 I am afraid that if nitroglycerin ointments or nifidepine ointments are made from spasm, it will take longer to heal, since they also bleed more due to vasodilation.
9 from the edema is now formed fringe or not? after the first operation, edema and formed fringe. ice after a day is useless to apply? the doctor generally said ice inflammation can give. how to quickly remove the swelling? and then she removed the fringe, and after removing the edema, which can again form it.
Thank you in advance for your feedback, understanding and your advice. I am very scared that all this will go back to the chronicle. two months later I have a year of torture after all interventions.

Spasm after removal of hemorrhoids

Among the many problems that arise in patients who underwent surgery to remove hemorrhoids, one of the urgent is the difficulty associated with normal bowel movement. The cause of difficulty in defecation may be a sudden spasm (strong muscle contraction) of the anal canal before the bowel movement or immediately after the feces began to come out.

To understand the causes of anus spasm, you should find out what the sphincter of the rectum itself is. This organ consists of two parts, external and internal. The main task of the sphincter is to control the process of removing the contents of the intestine (feces and gases) to the outside.

The external part (external) is a striated muscle that covers the anus. As a rule, the size of such a muscle ring does not exceed 10 centimeters in circumference and has a thickness of not more than 2.5 centimeters. The vast majority of people can consciously control the compression or extension of these muscles, thereby regulating the passage of gases and feces in any form.

The internal part of the organ is a ring-shaped smooth muscle structure surrounding the anal canal of the rectum. Its length is not more than 3 cm, its thickness is not more than 0.5 cm. A person cannot control this part of the sphincter, therefore its muscles contract and unclench reflexively. The main function of the inner part of the sphincter is the role of a kind of valve, which does not allow gases and feces to pass through the anus, unless a person specifically bothers to do this. In the normal (healthy) state of the body, the stool located in the rectum acts as an irritating factor for reflex compression and relaxation of the inner part of the sphincter.

With hemorrhoids and after its removal, the bowel movement can be difficult due to spasm.

The mechanism of spasm after removal of hemorrhoids

A sharp contraction of the muscles of the anal ring is provoked by irritation of the nerve endings, which are found in large numbers, both in the anus and in the mucosa of the anal canal. Especially often, spasm is observed during the development of moderate and severe forms of hemorrhoids, as well as in the postoperative period after removal of hemorrhoids.

A spasm after removal of hemorrhoids not only brings discomfort and discomfort due to the inability to empty the intestines by natural defecation, but is often accompanied by severe pain. In addition, it interferes with the normal process of wound healing of the removed hemorrhoid cones remaining in place.

How to deal with cramping after removal of hemorrhoids?

Currently, the pharmacological industry offers a variety of tools and drugs that provide effective relief of symptoms that cause spasm of the anal ring after removal of hemorrhoids. These are mainly local anesthetics such as rectal suppositories, ointments and gels. Also used in the form of injections and tablets are analgesics and antispasmodics. After removing hemorrhoids, it is practiced to take sedentary baths with warm water or herbal decoctions from medicinal plants aimed at preventing muscle contractions. And for the preparation of decoctions used when taking a warm bath, use such plants - sage, chamomile, as well as oak bark.

It is noted by many proctologists that contribute to the relaxation of the muscles of the anal sphincter after removal of hemorrhoids, which include nitroglycerin. For example, 0.4% nitroglycerin ointment, which relieves spasm after removing hemorrhoids, is very popular among patients.

A prerequisite for patients suffering from spasms of the anal ring after surgery to remove hemorrhoids is careful hygiene. You should also observe personal hygiene before performing any manipulations aimed at stopping the spasm.

Possible consequences

The appearance of negative consequences after surgery during the elimination of hemorrhoids is directly dependent on the stage of the disease, the chosen method of radical treatment, the presence of concomitant pathologies in the patient, etc.

The main factor in the occurrence of complications after surgery for hemorrhoids should be considered non-compliance with medical recommendations by patients.

Pain syndrome

A frequent postoperative consequence is acute excruciating pain that occurs when the anesthesia ceases. The appearance of this syndrome is associated with damage during the operation of nerve endings, which are in large numbers in the problematic anorectal region.

Pain is eliminated by the appointment of painkillers. Sometimes narcotic drugs are used for these purposes.

Anemia is characterized by a decrease in the number of red blood cells in the bloodstream, a decrease in hemoglobin levels. The decrease in the blood of iron-containing trace elements, which occurs with severe anemia, disrupts the heart. The development of this formidable complication is caused by postoperative massive bleeding.

The fight against anemia is to stop bleeding, to replenish the body with the missing trace elements through proper nutrition and the appointment of iron-containing drugs.

Rectal prolapse

If during the operation of hemorrhoids the violation of the integrity of the neuromuscular tissues of the rectum occurs, rectal prolapse may occur. The indicated postoperative complication can be eliminated by surgical manipulation to remove the protruding intestine. In addition to this, drug therapy and exercise therapy are prescribed.

Rectal prolapse can be eliminated by surgical manipulation.

Acute thrombosis

Thrombosis is a blockage of the vessel wall by a thrombus formed from fibrin and proteins. A change in the composition of the blood and its thickening is caused by congestion in the pelvic area. A blood clot forms in the anal area damaged during surgery. Signs of acute thrombosis should be considered a strong pain syndrome, difficulties in passing through the process of defecation.

This postoperative consequence is eliminated by surgical intervention with further anti-inflammatory and analgesic therapy.

Necrosis of the anorectal region is a serious complicated condition of hemorrhoids, threatening to lead the patient to death. Tissue death is formed due to a violation of blood flow. Complication is manifested by inflammatory degenerative necrotic processes, excruciating pains. The problem area becomes dark crimson or blue. The fight against necrosis consists in the removal of a dead section of tissue and the medical elimination of symptoms.

Causes of proctalgia

The intestinal cavity is tissue with a large number of nerve endings. During a sharp compression of the internal sphincter or with mechanical damage to the rectum, signals enter the brain and cause pain. A number of reasons can cause irritation of the anus and sphincter, which are caused by both the work of internal organs and the psychoemotional state of a person. Factors can be divided into 2 groups: primary and secondary. Primary causes include:

  • unstable state of mind
  • neurosis,
  • sudden mood swings,
  • violations of the autonomic system.

Primary causes, as a rule, are not associated with mechanical damage to the walls and mucous membranes of the rectum. Secondary factors causing sphincter spasm include:

  • inflammation of hemorrhoids and surgical removal of hemorrhoids,
  • cracks and wounds of the rectum,
  • Crohn's disease,
  • diarrhea and bowel problems,
  • injuries of the sacrum and tailbone,
  • childbirth
  • oncological pathologies of the pelvic cavity.
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Symptoms of the disease

Proctalgia is a pathological deviation of the muscular system of the rectum. Manifestations of the problem:

  • acute pain attacks, extending to the intimate area and across,
  • painful bowel movements
  • a pain symptom that disappears when taking a bath,
  • cramps occur at night.
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Types of cramps with hemorrhoids

Painful rectal contractions are classified depending on what stage the disease is at, how long the pain lasts, the nature of the etiology of the spasm. By duration, there are:

  • transient cramps
  • prolonged pain syndrome.

By origin distinguish:

  • primary spasm (not associated with mechanical damage to the anus and internal sphincter),
  • secondary spasm (pathology and trauma of the anus).
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Diagnostics

At the first manifestations of the disease, you need to contact a proctologist who will carry out the necessary diagnostic measures, make an accurate diagnosis and select the relevant treatment methods. An important step in the diagnosis is to collect an anamnesis: through an oral question, the doctor determines the degree and quality of the manifestation of symptoms, and also establishes the fact of concomitant diseases and injuries of the pelvic organs, they often cause rectal convulsions. Further research activities include:

A more detailed examination of the intestine is carried out with a sigmoidoscope.

  • visual examination of the external sphincter and anus ring,
  • palpation of the anus: patient on a gynecological chair, with a secondary spasm, the examination is performed in a position on the side, knees bent underneath,
  • sigmoidoscopy - a deep examination of the rectal mucosa, involving the use of a sigmoidoscope,
  • examination of the rectum with an endoscope or x-rays.
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How to treat cramping?

In order to quickly relieve seizures of the rectum and stop the manifestations, you can use alternative medicine, medication or radical methods - surgical intervention. The treatment method is selected depending on the degree of neglect of the disease and its manifestations. Before resorting to one of the methods, it is necessary to consult a doctor and strictly follow all instructions.

You can relieve spasmodic pain after surgery to remove hemorrhoids with topical drugs or systemic medicines. Often, the doctor selects a comprehensive treatment to relieve the patient of all the symptoms. For example, if a patient has problems with defecation, he is prescribed a laxative, for disorders of the nervous system, sedatives or psychostimulants are prescribed:

Nigepan relieves inflammation in the problem area.

  • creams and ointments are most often used to treat the sphincter: Relief, heparin ointment, Hepatrombin G,
  • candles that “soothe” the inflamed foci: “Nigepan”, “Ultraproct”, “Betiol”,
  • as a painkiller, tablets are used, for example, Detralex, No-Shpa, Nimesil,
  • For systemic use, Trimedat and Buscopan are suitable.

The use of "Trimedat" relieves pain at the first manifestation.

Surgery to eliminate spasm

Surgical intervention is resorted to if it is no longer possible to remove cramp of the rectum after removing hemorrhoids with medication. Most often, sphincterotomy is performed. This operation involves an incision in the sphincter, which helps reduce pressure on the blood vessels and thereby relieve spasm. The operation is carried out under general anesthesia and requires recovery: diet, taking medications, special baths and lotions.

Funds from the people

Use of traditional medicine is possible only after consultation with a proctologist. If there are allergic reactions to a particular component, it is necessary to abandon its use. Folk remedies are especially effective when they are used in parallel with drugs.

Spasms baths

Sitting baths will help relax the sphincter, reduce pressure on blood vessels and quench pain. The best bath recipes:

A manganese bath helps with cramps.

  • Dissolve a little potassium permanganate in warm water and sit in such a liquid for 15-20 minutes, at the end of the procedure, treat the sphincter with an alcohol antiseptic. The course of treatment in this way is 7-10 days.
  • Sedentary bath of decoction of St. John's wort, yarrow, oak bark.
  • Mix knotweed grass with 2 tbsp. liters of olive oil and 1 liter of warm boiled water. Take such a sitz bath for 20-30 minutes, after the procedure, lubricate the anal ring with antiseptic and oil.
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Swabs and candles

To get rid of pain symptoms, homemade candles from the pulp of raw potatoes with honey, ice (frozen herbal decoction) are suitable. They will soothe sore spots and play the role of an antispasmodic-analgesic. Tampons made at home will also be effective:

  • Take 2 tbsp. L mix herbs (water pepper, flaxseed flowers, oak bark), crush and mix with melted pork fat. Leave to freeze for a day. Enter into the rectum 1-2 times for 2-4 hours. The course of treatment is 7-10 days.
  • mix half a gram of melted pork with 4-5 tsp. crushed hops and add 2 tbsp. l hypericum. After solidification (12 hours) and cooling, enter the passage for several hours.
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Cramps from cramping

Enemas from sphincter spasm are prepared on the basis of herbal decoction using Octenisept (1:10 proportion) or Collargol (not more than 50 ml per procedure). As a basis, it is better to use a decoction of sage, calendula or St. John's wort. Before use, the enema is lubricated with petroleum jelly, and after the procedure, the sphincter is treated with an antiseptic. Before use, be sure to consult your doctor.

Watch the video: Hemorrhoid Removal Hemorrhoidectomy (December 2019).