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What causes anal pain post defecation?

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Posted on Tue, 10 May 2016
Question: I had anal pain and doctor suggested an abscess drained and fistulatomy surgery done, Now there is an open would left in my anal. surgery done 10 days back and now taking rest.
My question is

1. I still have mild anal pain after bowel movement( after passing stool) for 4 hours morning approx, is this normal, why does this anal pain comes even after abcess drained and fistulatomy done. How long it takes to have back to no pain. Doctor has given only pain killers ( antibiotics). My bowel movement is very normal and easy , just that anal pain mild is still there

2. Some pus discharge is there

3. Can I do exercise now , when can I start doing
4. How can I avoid abcess in future
doctor
Answered by Dr. T Chandrakant (13 hours later)
Brief Answer:
As answered in details.

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Male/39 - Surgery done on 17/2/2016 - Fistulectomy with incision and drainage (evacuation) of peri-anal abscess - read the surgical procedure report - now open wound and some questions:

1. I still have mild anal pain after bowel movement( after passing stool) for 4 hours morning approx, is this normal, why does this anal pain comes even after abscess drained and fistulectomy done. How long it takes to have back to no pain. Doctor has given only pain killers ( antibiotics). My bowel movement is very normal and easy , just that anal pain mild is still there
> Since the floor of the abscess must be granulating, contracting and trying to heal, there must be still a raw area which causes pain on defecation and the muscles nearby go into reflex spam causing persistence of the pain for some time after passing motion. It takes around 1 to 3 weeks to have a stage of no pain depending upon the nature of healing that is going on, your pain tolerance and the medicines are are taking. The pain is mild and will go way.

2. Some pus discharge is there>
> Since there is an open wound, it comes in contact with the fecal loads of bacteria and hence some pus would be there obviously.

3. Can I do exercise now , when can I start doing.
> Depends upon which exercises you want to do. I think this is just 10 days, it is better to wait for some time and start only on complete healing.

4. How can I avoid abscess in future.
> This is a tricky question. It is not known for sure why such abscesses occur. The most probable cause is the infection of the crypts in the anal canal and then spread. I think to maintain normal diet so that there is no extra intestinal infection, no constipation.

I hope these answers your queries.
Please feel free to asks for further relevant queries if you feel that there is a gap of communication.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (6 hours later)
Just a follow up question, though i am a male, i use female sanitory napkin to manage pus disharge , i use this and can sit and walk reasonably well, Can i start going for work or more rest needed at home ? I am a finance executive and more sitting job, hence if i make sure i do not sit long , is it fone to resume work ,
doctor
Answered by Dr. T Chandrakant (15 minutes later)
Brief Answer:
As explained.

Detailed Answer:
Thanks for your feedback.
It is just 12 days.
Healing is in good progress.
There is no wrong using the female sanitary napkins, provided they are sterile.
Good that you can sit and walk reasonable well, still the pain is there as well well as pus discharge. Going to work may cause a problem in changing the dressing which should be changed whenever wet.

If possible try to relax at home till a good recovery occurs.
If at all it is a must then you can use doughnut seats/cushions, even at home and at office to take off the pressure on the healing area.

If it is not mandatory, let the wound heal before you join office.
Please let me know what you think and your experience at sitting long, may be with doughnut cushions.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (8 hours later)
My doctor has asked me that when i do sitz bath in hot water, ( thats the only thing needed, no medicines) i should OPEN the anus to open the wound, ( i mean surgery wound) to allow it to heal first from inside, It looks like an open wound near anus , i would like to take a second opinion on this how you as an experienced doctor thinks about this, is this really necessary.
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
Same.

Detailed Answer:
This is of utmost importance as when the wound heals from within, there is no chances for recurrence.
You Doctor is 100% correct.
This is the standard practice in such cases.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (2 days later)
Just a follow up question, when we do sitz bath, should we use dettol or some anteseptic in water, and how long after surgery this sitz bath is needed, currently i do 3 times per day in mild hot water, since last 2 weeks from the day of surgery.
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
As explained below.

Detailed Answer:
No need to use any dettol or antiseptic in water. Not needed. Sitz bath is basically to sooth the muscles, clean the wound and have relaxation.
This is to be continued till the wound is healed and the area becomes painless.
Please continue 3 times a day.

Please feel free to ask for any further relevant queries if you need to.

Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 14831 Questions

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What causes anal pain post defecation?

Brief Answer: As answered in details. Detailed Answer: Hi. Thanks for your query. To recapitulate: Male/39 - Surgery done on 17/2/2016 - Fistulectomy with incision and drainage (evacuation) of peri-anal abscess - read the surgical procedure report - now open wound and some questions: 1. I still have mild anal pain after bowel movement( after passing stool) for 4 hours morning approx, is this normal, why does this anal pain comes even after abscess drained and fistulectomy done. How long it takes to have back to no pain. Doctor has given only pain killers ( antibiotics). My bowel movement is very normal and easy , just that anal pain mild is still there > Since the floor of the abscess must be granulating, contracting and trying to heal, there must be still a raw area which causes pain on defecation and the muscles nearby go into reflex spam causing persistence of the pain for some time after passing motion. It takes around 1 to 3 weeks to have a stage of no pain depending upon the nature of healing that is going on, your pain tolerance and the medicines are are taking. The pain is mild and will go way. 2. Some pus discharge is there> > Since there is an open wound, it comes in contact with the fecal loads of bacteria and hence some pus would be there obviously. 3. Can I do exercise now , when can I start doing. > Depends upon which exercises you want to do. I think this is just 10 days, it is better to wait for some time and start only on complete healing. 4. How can I avoid abscess in future. > This is a tricky question. It is not known for sure why such abscesses occur. The most probable cause is the infection of the crypts in the anal canal and then spread. I think to maintain normal diet so that there is no extra intestinal infection, no constipation. I hope these answers your queries. Please feel free to asks for further relevant queries if you feel that there is a gap of communication.