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Hi Dr. Bhagyesh V. XXXXXXX Sir @ HealthCare Magic, In
Question: Hi Dr. Bhagyesh V. XXXXXXX Sir @ HealthCare Magic,
In our earlier conversation I have told you that I am suffering from fistula in ano. Its been more than a week since I got it operated by a reputed MS surgeon here in VIZAG. I was discharged after 3 days of hospitalization with IV antibiotics without any uneventful situation. However, there is a serious post operative pain lasted for 1 week and gradually pain is decreasing significantly. Also the doctor told me that the wound is healing well after my first consultation to his clinic.
I am currently using cifran 500 twice a day followed by sitz baths and a dressing in the morning. I am assuming the surgery happened as desired however I am seeing some complications post operation which is quite uncomfortable and dreadful for me.
The symptoms are I have been experiencing some pain in the intestines and my stomach feels bloated causing gas to pass through anus and also sometimes from the surgical site(not always). I did experience the similar situation when I had last operated for a perianal abscess which finally resulted in a fistula in ano formation. Due to this cause I am also feeling the same sensation again and told the doctor that the gas is sometimes leaking from fistula to which he replied it is common to leak gas and some stool through the passage and confronted me that it goes with the healing slowly after some days.
But I am afraid of this bloating and also gas formation everyday... apart from this I feel my anus got contracted than earlier and stool passage has become a very painful thing for me. I am feeling the urge to defecate early in the morning however the stool coming from Anus is very painful and unbearable and feeling that this will again cause some complications like fissure or a new fistula due to anal gland infections. I tried to insert a finger like earlier (for applying a creams for my fissure)to check but couldn't do it as I am feeling it has become narrower. I am attaching few reports to you kindly have a look and suggest something on my case.
I am really very much thankful to your help and strength that you have given me in my earlier conversations to which gathered I gathered some strength and courage for this operation. Hoping the same again and will appreciate your kind response.
Thanks again!
In our earlier conversation I have told you that I am suffering from fistula in ano. Its been more than a week since I got it operated by a reputed MS surgeon here in VIZAG. I was discharged after 3 days of hospitalization with IV antibiotics without any uneventful situation. However, there is a serious post operative pain lasted for 1 week and gradually pain is decreasing significantly. Also the doctor told me that the wound is healing well after my first consultation to his clinic.
I am currently using cifran 500 twice a day followed by sitz baths and a dressing in the morning. I am assuming the surgery happened as desired however I am seeing some complications post operation which is quite uncomfortable and dreadful for me.
The symptoms are I have been experiencing some pain in the intestines and my stomach feels bloated causing gas to pass through anus and also sometimes from the surgical site(not always). I did experience the similar situation when I had last operated for a perianal abscess which finally resulted in a fistula in ano formation. Due to this cause I am also feeling the same sensation again and told the doctor that the gas is sometimes leaking from fistula to which he replied it is common to leak gas and some stool through the passage and confronted me that it goes with the healing slowly after some days.
But I am afraid of this bloating and also gas formation everyday... apart from this I feel my anus got contracted than earlier and stool passage has become a very painful thing for me. I am feeling the urge to defecate early in the morning however the stool coming from Anus is very painful and unbearable and feeling that this will again cause some complications like fissure or a new fistula due to anal gland infections. I tried to insert a finger like earlier (for applying a creams for my fissure)to check but couldn't do it as I am feeling it has become narrower. I am attaching few reports to you kindly have a look and suggest something on my case.
I am really very much thankful to your help and strength that you have given me in my earlier conversations to which gathered I gathered some strength and courage for this operation. Hoping the same again and will appreciate your kind response.
Thanks again!
Brief Answer:
narrowing felt is due to painful spasm of anal muscles.
Detailed Answer:
Hello Azharuddin
Welcome to Ask A Doctor service.
First of all, let me compliment you for gathering courage and get the surgery done.
Kindly find my detail answers after reviewing your attachments.
* Narrowing felt by you at the anal region is due to painful spasm of the anus muscles in
early postoperative period, gradually once the healing is there, you can feel normal
passage.
* The photo snap of operated part is showing very good healing tissue in form of red
granulation tissue, which is a good sign.
* The gas and nausea with abdomen discomfort is due to the absence of antacid in
prescription of 23rd October. You can add antacid syrup 2 teaspoonfuls 3 times a day
to recover from that.
* The passage of flatus and stool to some extent from the wound is also a normal part of
recovery and should not be panic for that.
* As the amount of pain is becoming lesser day by day, overall progress is good.
You have to continue regular sitz bath, dietary measures, dressing as advised.
Additionally, I would like to ask that which ointment or creams are given for dressing purpose?
Awaiting your response.
Regards.
narrowing felt is due to painful spasm of anal muscles.
Detailed Answer:
Hello Azharuddin
Welcome to Ask A Doctor service.
First of all, let me compliment you for gathering courage and get the surgery done.
Kindly find my detail answers after reviewing your attachments.
* Narrowing felt by you at the anal region is due to painful spasm of the anus muscles in
early postoperative period, gradually once the healing is there, you can feel normal
passage.
* The photo snap of operated part is showing very good healing tissue in form of red
granulation tissue, which is a good sign.
* The gas and nausea with abdomen discomfort is due to the absence of antacid in
prescription of 23rd October. You can add antacid syrup 2 teaspoonfuls 3 times a day
to recover from that.
* The passage of flatus and stool to some extent from the wound is also a normal part of
recovery and should not be panic for that.
* As the amount of pain is becoming lesser day by day, overall progress is good.
You have to continue regular sitz bath, dietary measures, dressing as advised.
Additionally, I would like to ask that which ointment or creams are given for dressing purpose?
Awaiting your response.
Regards.
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
follow up.
Detailed Answer:
Hi
Welcome for follow up.
Kindly find details below.
* Add to consume capsule omeprazole ( 20 mg ) morning and evening before meals.
* Give metronidazole gel to the GP to apply over the inside part of operation site for best
results over and above what is being done currently.
* Ispaghula can be considered to be taken on a regular basis now till the complete
recovery, there is no harm in it.
* Flatus part will remain at the site, till the wound is closed completely, nothing extra
can be done for that except getting soft stools and avoiding stress thinking of that.
Kindly convey to me the amount of narrowing you are feeling at this time ( like can you insert your finger inside anus without any resistance or not ? )
Thanks.
Take care.
follow up.
Detailed Answer:
Hi
Welcome for follow up.
Kindly find details below.
* Add to consume capsule omeprazole ( 20 mg ) morning and evening before meals.
* Give metronidazole gel to the GP to apply over the inside part of operation site for best
results over and above what is being done currently.
* Ispaghula can be considered to be taken on a regular basis now till the complete
recovery, there is no harm in it.
* Flatus part will remain at the site, till the wound is closed completely, nothing extra
can be done for that except getting soft stools and avoiding stress thinking of that.
Kindly convey to me the amount of narrowing you are feeling at this time ( like can you insert your finger inside anus without any resistance or not ? )
Thanks.
Take care.
Above answer was peer-reviewed by :
Dr. Kampana
Hi Sir,
Thank you so much for such positive response by always keeping patients symptoms in view.
After first week of prescription I was only given cifran 500 for the second week but I have been experiencing flatus problem post operation date.
As of now I am currently using only cifran 500 twice a day and no other medications.
Coming to my diet morning I am having an idly, lunch with a cup rice and any veg curry along side galloping a cup of curd and dinner again a cup of rice and veg curry with 2 apples and 1 mosambi in between the day.
My only worry is the narrowing of Anus and resulting in harder or painful defecation. (I understand the pain is because of the inflammation still present around that area) but this narrowing of anus again results in causing a fissure or fistula which have happened to me earlier when I had a perianal abscess.
Sometimes, I am consuming psyllium husk alternatively to soften the stool hoping this shouldn't cause any problems.
In order to eliminate flatus and bloating do you suggest me adding an antacid along with cifran prescription ? (though I am not prescribed any other drugs except cifran twice a day)
Also I wasn't given any ointments to apply at the surgical site.
Dressings are being performed by nearby RMP doctor by cleaning the wound with hydrogen peroxide dipped cotton ball and putting some NS at the sights. Later, he wets the gauze with betadine and inserts into the wound area and finally covers with a bandage.
You suggestions or insights are highly appreciated.
Thank you so much for such positive response by always keeping patients symptoms in view.
After first week of prescription I was only given cifran 500 for the second week but I have been experiencing flatus problem post operation date.
As of now I am currently using only cifran 500 twice a day and no other medications.
Coming to my diet morning I am having an idly, lunch with a cup rice and any veg curry along side galloping a cup of curd and dinner again a cup of rice and veg curry with 2 apples and 1 mosambi in between the day.
My only worry is the narrowing of Anus and resulting in harder or painful defecation. (I understand the pain is because of the inflammation still present around that area) but this narrowing of anus again results in causing a fissure or fistula which have happened to me earlier when I had a perianal abscess.
Sometimes, I am consuming psyllium husk alternatively to soften the stool hoping this shouldn't cause any problems.
In order to eliminate flatus and bloating do you suggest me adding an antacid along with cifran prescription ? (though I am not prescribed any other drugs except cifran twice a day)
Also I wasn't given any ointments to apply at the surgical site.
Dressings are being performed by nearby RMP doctor by cleaning the wound with hydrogen peroxide dipped cotton ball and putting some NS at the sights. Later, he wets the gauze with betadine and inserts into the wound area and finally covers with a bandage.
You suggestions or insights are highly appreciated.
Thanks for your kind advise.
I did just tried inserting a finger into my anus and felt that it is swollen and narrowed. I am really worried now.
Considering my past, I have had passed a hard stools which developed into a fissure and progressed as a perianal abscess which finally resulted in a fistula.
I am really feeling depressed and dreadful about this situation as it may cause another problem after my recovery period.
I did just tried inserting a finger into my anus and felt that it is swollen and narrowed. I am really worried now.
Considering my past, I have had passed a hard stools which developed into a fissure and progressed as a perianal abscess which finally resulted in a fistula.
I am really feeling depressed and dreadful about this situation as it may cause another problem after my recovery period.
Brief Answer:
follow up .
Detailed Answer:
Hi
* The currently felt narrowing is due to painful spasm as indicated previously and the
same is not going to create problem in future as the healing will progress, the pain will
be disappearing and the pain induced spasms will be no more present at that time.
* What you had experienced in past was the mode of presentation as hard stool passed
and you noticed abscess or fistula. It is not the hard stool which is causing it, it is just
manifesting or showing up the underlying issue.
* So if you will panic like this , it will surely hamper your recovery from psychology point
of view only.
* Try to make yourself more relax and follow the said instructions, you will be surely fine
absolutely without any future issues.
* Maintain hydration with plenty of liquids and consume high fiber diet with plenty of
green leafy veg, cereals, pulses, legumes, organic fresh fruits for faster recovery.
* Add a multivitamin tablet as zincovit or becosule whatever available in nearby chemist
which will support healing better.
Wish you fine recovery.
Take care.
follow up .
Detailed Answer:
Hi
* The currently felt narrowing is due to painful spasm as indicated previously and the
same is not going to create problem in future as the healing will progress, the pain will
be disappearing and the pain induced spasms will be no more present at that time.
* What you had experienced in past was the mode of presentation as hard stool passed
and you noticed abscess or fistula. It is not the hard stool which is causing it, it is just
manifesting or showing up the underlying issue.
* So if you will panic like this , it will surely hamper your recovery from psychology point
of view only.
* Try to make yourself more relax and follow the said instructions, you will be surely fine
absolutely without any future issues.
* Maintain hydration with plenty of liquids and consume high fiber diet with plenty of
green leafy veg, cereals, pulses, legumes, organic fresh fruits for faster recovery.
* Add a multivitamin tablet as zincovit or becosule whatever available in nearby chemist
which will support healing better.
Wish you fine recovery.
Take care.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
follow up .
Detailed Answer:
Hi
* Becosule to be taken once a day only.
* And do not decide time of recovery from now, as it will take surely some more time
than a week as the photo is showing much depth of the operative part.
But as the healing is faster, be rest assured for speedy recovery.
Wish you best recovery.
Do feel free for any further doubts.
Thanks for keeping trust in our medical services.
follow up .
Detailed Answer:
Hi
* Becosule to be taken once a day only.
* And do not decide time of recovery from now, as it will take surely some more time
than a week as the photo is showing much depth of the operative part.
But as the healing is faster, be rest assured for speedy recovery.
Wish you best recovery.
Do feel free for any further doubts.
Thanks for keeping trust in our medical services.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you sir for your assurance. I hope I will feel better by next week or so.... will surely keep posted about my recovery and progress.
Also I am planning to visit the doctor next week i.e on Tuesday till then I will consume omeprazole, cifran, becosules twice a day and apply metronidazole gel at my surgical site or to the gauze that's being put there.
Once again,Thanks for your positive words and help in making me understand better.
All the very best!
Also I am planning to visit the doctor next week i.e on Tuesday till then I will consume omeprazole, cifran, becosules twice a day and apply metronidazole gel at my surgical site or to the gauze that's being put there.
Once again,Thanks for your positive words and help in making me understand better.
All the very best!
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