What I was told before I went home
Before I left hospital, a nurse went through the bleeding with me. She said some bleeding was expected, especially in the first few days, and that it should get less over time. She told me what would mean calling them straight away. Then she wrote the ward’s number on my discharge sheet and said, “We expect these calls. Use it.”
I didn’t take in half of it. I was groggy and sore. But I kept that sheet on the bathroom shelf, and I read it a lot.
Every surgery is different. Mine was one kind of hemorrhoidectomy, and my team’s advice was for my operation. Other people’s teams may say different things.
Days 1 to 3
The first bowel movement came with bright red blood on the paper and a few drops in the bowl. I’d been warned, but it still frightened me.
Between times, the gauze pads showed a pinkish, blood-tinged stain. The nurse had said this was wound fluid mixed with blood. There was some light spotting on my underwear too. To me it looked like a light period. It stained, but it didn’t drip or soak through.
The bleeding stopped on its own within a few minutes of each bowel movement. That was one of the things I’d been told to watch.
I stopped wiping and rinsed instead, with a wash bottle and then the sitz bath. Wiping hurt, and the nurse had said friction could irritate the wound.
The rest of week 1
The bleeding got a little less each day. Mostly it came during and just after bowel movements. It was bright red. My team said the colour is usual for this area. What mattered was how much there was and whether it stopped. Some days there was a clear or yellowish fluid on the pad as well.
It wasn’t a smooth line. After one harder bowel movement there was a bit more blood than the day before, and I panicked. I checked the sheet: it was still streaks and drops, and it stopped within minutes. If it hadn’t stopped, or had kept increasing, I’d have rung. The next day was lighter again.
My team had been firm about one thing: keep stools soft and don’t strain. They said hard stool passing over the wound was the most common cause of extra bleeding, but they still wanted to hear about any bleeding on the list. I took that seriously. Fibre, lots of water, and the stool softening they recommended. I also rested, and didn’t lift anything heavy.
I checked every piece of paper and every pad. I was exhausted by it. After a few days the days started to run together, and I honestly couldn’t have said whether Tuesday had been better or worse than Wednesday.
Around day 10
I’d had a few quiet days. Barely any blood. I thought the bleeding part was over.
Then I went to the toilet and there was noticeably more bright red blood than I’d seen for days. More than spotting. My heart raced.
I rang the number on the sheet. The nurse asked how much, whether it had stopped, whether there were clots, and whether I felt dizzy. She explained that this can happen around one to two weeks after surgery, when a scab or stitch comes away as the wound heals. It’s called a secondary haemorrhage. She said it isn’t always serious, but it always needs checking.
They asked me to come in. I was assessed, it settled with rest, and I went home the same day. Someone in the waiting area told me theirs had needed a small procedure to stop it. That’s why they check.
Weeks 3 and 4
The bleeding faded to the odd streak on the paper after a harder bowel movement. By about four weeks it had mostly stopped.
At my follow-up, the surgeon asked when the bleeding had eased. I couldn’t remember. I knew it had, but not when.
What stayed with me
I wish I’d known exactly what to expect: the amount, the colour, the timing. And I wish I’d known sooner that calling wasn’t a bother. Every time I rang, they were kind about it.
How other people’s experiences differed
People’s recoveries vary, and these differences come up often:
- Some people have almost no bleeding after day three. Others have light bleeding for three to four weeks.
- A secondary haemorrhage always needs checking the same day. It often settles with rest, but sometimes it needs a procedure to stop it.
- Some surgical teams say to go to A&E or the emergency department for any increase in bleeding. Others give more detailed guidance about what to watch at home. Your own team’s advice comes first.
When to contact your surgical team
Contact your surgical team straight away, or go to A&E or the emergency department if you can’t reach them quickly, if:
- Bleeding is heavy — dripping rather than spotting, or soaking through a pad within an hour
- There is more than a few drops of blood in the toilet bowl
- Bleeding doesn’t stop on its own within a few minutes of a bowel movement
- You need to press on the area to stop the bleeding
- You are passing blood clots, or have clots with a feeling of pressure in your rectum
- Bleeding was improving and is now getting worse, or each bowel movement brings more blood than the last
- There is bleeding between bowel movements that is new after it had settled, or is more than light spotting
- Bleeding suddenly increases after a quiet spell, especially around one to two weeks after surgery
- You feel lightheaded, dizzy or faint, notice a racing heart, or look pale
- Bleeding comes with fever or increasing pain
- You pass dark red or black, tarry stools
- Bleeding carries on beyond about six weeks, or comes back after it had stopped — tell your team or doctor rather than assuming it’s still healing
- You are worried about the amount of bleeding — your team expects these calls, and it is always better to check than to worry at home
If bleeding is heavy or won’t stop, or you feel faint, dizzy, breathless or your heart is racing, call emergency services or go to A&E or the emergency department now. Don’t drive yourself.