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My wife had her hemorrhoids removed and it’s been a year and…

Customer Question
Hello my wife had...

Hello my wife had her hemorrhoids removed and it’s been a year and she has odor and leakage What can she do

Doctor's Assistant: Have you seen a doctor about this yet? What medications are you taking?

Nothing now she already took all the medication that her doctor recommended

Doctor's Assistant: What medications do you take daily? Are you allergic to any medications?

One sec plz

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Plaquenil

Submitted: 7 months ago.Category: Medical
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Customer reply replied 7 months ago
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call.
Customer reply replied 7 months ago
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Answered in 11 minutes by:
12/12/2017
Doctor: Dr. Muneeb Ali, Doctor replied 7 months ago
Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,926
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Hi,

Welcome to JA and thanks for this question. I'm sorry to hear about your wife's symptoms. Actually, she seems to be suffering from anal incontinence which can be due to multiple causes but given the removal of her hemorrhoids, it is possible that her anal sphincter (valve) was damaged during the procedure which is causing this problem right now. Now the first step would be to diagnose the actual cause of this which would include getting tests done such as,

  • Balloon expulsion test. A small balloon is inserted into the rectum and filled with water. She is then asked to go to the toilet and expel the balloon. The length of time it takes to expel the balloon is recorded. A time of one minute or longer is usually considered a sign of a defecation disorder.
  • Anal manometry. A narrow, flexible tube is inserted into the anus and rectum. A small balloon at the tip of the tube may be expanded. This test helps measure the tightness of her anal sphincter and the sensitivity and functioning of her rectum.
  • Anorectal ultrasonography. A narrow, wand-like instrument is inserted into the anus and rectum. The instrument produces video images that allow her doctor to evaluate the structure of her sphincter.
  • Proctography. X-ray video images are made while she has a bowel movement on a specially designed toilet. The test measures how much stool her rectum can hold and evaluates how well her body expels stool.
  • Proctosigmoidoscopy. A flexible tube is inserted into her rectum to inspect the last two feet of the colon (sigmoid) for signs of inflammation, tumors or scar tissue that may cause fecal incontinence.
  • Colonoscopy. A flexible tube is inserted into her rectum to inspect the entire colon.
  • Magnetic resonance imaging (MRI). MRI can provide clear pictures of the sphincter to determine if the muscles are intact and can also provide images during defecation

Once the diagnosis is made then she can be treated with various modalities which can include,

  • Anti-diarrheal drugs such as loperamide hydrochloride (Imodium) and diphenoxylate and atropine sulfate (Lomotil)
  • Bulk laxatives such as methylcellulose (Citrucel) and psyllium (Metamucil)
  • Injectable bulking agents such as Dextranomer Microspheres/Hyaluronate Sodium in 0.9 % NaCl (Solesta) are injected directly into the anal canal
  • Exercise and other therapies If muscle damage is causing fecal incontinence, I would recommend a program of exercise and other therapies to restore muscle strength. These treatments can improve anal sphincter control and the awareness of the urge to defecate

    • Biofeedback. Specially trained physical therapists teach simple exercises that can increase anal muscle strength. People learn how to strengthen pelvic floor muscles, sense when stool is ready to be released and contract the muscles if having a bowel movement at a certain time is inconvenient.

    • Sacral nerve stimulation (SNS). The sacral nerves run from your spinal cord to muscles in your pelvis. These nerves regulate the sensation and strength of your rectal and anal sphincter muscles. Implanting a device that sends small electrical impulses continuously to the nerves can strengthen muscles in the bowel.

    • Posterior tibial nerve stimulation (PTNS/TENS). This minimally invasive treatment may be helpful for some people with fecal incontinence

  • Surgery - If all else fails then surgery can be tried which can include various procedures to strengthen the sphincter.

I would suggest that she first get evaluated for the cause and then get started on the required treatment. This is a problem which CAN be solved quite effectively.

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Doctor: Dr. Muneeb Ali, Doctor replied 7 months ago

Would you like to know anything else? Any clarifications or additional questions that you might have, i would be happy to answer them for you. If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating.

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