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Irritation on wiping rectum post bowel movement. Recently done fissurectomy. What could the cause be?

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General & Family Physician
Practicing since : 2009
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I had a fissurectomy/sphinctorectomy a little over two months ago . It healed the fissure and I recovered from the surgery . However, now after I have a bowel movement and wipe my rectum gets irritated. The irritation, I believe is caused by the fact that I have to go back and re-wipe every 15 minutes for the next hour or so. Its not alot , (not getting on underwear), but enough to irritate my rectum. I thought maybe it was a hemmorrhoid problem but My doctor says that my hemmorrhoids do not look bad.But just in case it is he has me taking Proctofoam HC. He also advised me to try and strengthten my external sphincter muscle by doing keegle exercises. I can control my bowel movements and I have no other symptons , so what else could this be ? I am only 41 years old and soon I will be going back to work (construction), it is urgent that I solve this problem before I do. What do you think could it be somthing else?
Posted Tue, 21 May 2013 in Digestion and Bowels
Answered by Dr. Luchuo Engelbert Bain 4 hours later
Hi and thanks for the query,

Fissurectomy and sphincterorectomy are surgeries that are particular for two main reasons. Firstly because they are done in a region that is in constant contractile movements, and secondly because, they are regulated both by voluntary and reflex mechanisms.

It s but normal, at 2 months after such a surgery to experience rectal irritation. Simple measures are advised to reduce such symptoms. Drinking enough water, avoiding lots of spicy foods and pepper, eating vegetables, fibres and fruits are core issues in your management. Other signs of hemorroids like bleeding and thrombosis of hemorroidal veins must be excluded formally.

The Proctofoam HC should only be taken when the physician is completely convinced it s hemorroids, but for now, it does not have its place. Physiotherapy to strengthen and re adapt the sphincter muscles is a key issue in the management. Consulting a physiotherapist could be very useful.

Going to back to a heavy job as construction is not very safe at two months after surgery, especially if it requires long standing periods and carrying of weights. The ideal is resuming heavy duty jobs after 6 months.

I suggest you remain watchful, take the vegetables, fibres and fruits avoiding spices and pepper as mentioned. It is imperative however to report any unwanted effects like excess pain, bleeding and stool incontinence tendencies to your treating physician. I suggest you remain compliant to treatment for a few months.

Thanks and hope this helps. Do not hesitate asking further questions if need be.

Best regards,
Dr Luchuo, MD.
Above answer was peer-reviewed by
Follow-up: Irritation on wiping rectum post bowel movement. Recently done fissurectomy. What could the cause be? 13 hours later
I have already been doing a lot of physical work around my house while I am waiting to get called back to work. It does not seem to make it any worse but you said that it could cause damage , if so how? Also if performing exercises (keegles) is the right thing to do how long does it normally take to get back to normal from an operation like this?
Answered by Dr. Luchuo Engelbert Bain 23 minutes later
Hi and thanks for the query,
The impact of different physical exercises on the structures of the pelvis is actually very different. Activities that do not increase the pressure inside the abdomen to push down on pelvic components will apparently have less or no impact on the anal sphincter or rectal muscles. The effect on this does not come in a day and usually is cumulative, and certain consequences could be seen later, presenting themselves, not only as previous rectal irritation symptoms, but as prolapses. It is highly advisable, not to stay inactive per say, but to limit activities that cause you to strain with increase in intra abdominal pressure, or activities associated with prolonged standing, especially for the next two months.
Its appropriate for you to get back to your job. My advice is advice physically demanding activities with prolonged standing and exertion on the abdomen. I suggest there are other activities that you could undertake while there that are associated with minimal strain. Resuming your usual activity in 4 months (6 months after surgery) is an ideal thing to do.
Thanks and hope this helps as I wish you the best of health. Thanks and best regards,
I am very much predisposed to answer further questions if need be.
Luchuo, MD.
Above answer was peer-reviewed by
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