Hemorrhoids, being a common condition, a cut is one of the more thorough treatments available. But don’t underestimate the minor surgery of cutting hemorrhoids, because if you’re not careful, a minor surgery can lead to a large amount of bleeding. In general, according to the nature of bleeding can be divided into primary and secondary, and the reasons for bleeding are not the same. 1, hemorrhoids after surgery bleeding causes primary bleeding Most of the bleeding occurs within 24 hours after surgery, and is related to improper surgical operation, imperfect hemostasis, and patient non-cooperation. If the patient’s surgical incision is too large or too deep, injuring the larger arterial vessels, which is not detected in time during the operation, and heavy bleeding occurs. Or the ligature line is not strong after ligating the internal hemorrhoid nucleus during surgery, which makes the ligature line slip out. Or the anesthetic is injected too much into the hemorrhoid tissue and seems to be tight when tied, but when the excess hemorrhoid tissue is removed, the blood flows out and the tissue volume becomes smaller, making the ligature wire loose or slip off, and the unoccluded arterial dissection bleeds, etc. In addition the patient becomes constipated after surgery, or the patient is prematurely active, all of which can cause the patient to experience primary bleeding. Secondary bleeding Mostly occurs 5-14 days after surgery and is due to bleeding from the trabecular vessels formed by the necrotic shedding of the hemorrhoid nucleus. The hemorrhoid nucleus tissue is necrotic and sheds due to the disconnection of the blood supply, forming a fresh trabecular surface, where the arterial vessels are not yet atretic, the thrombus is dislodged, and the canal is open, and then bleeds very easily in the presence of strenuous activity. Internal hemorrhoid patients take penetration ligation therapy, stitches penetrate too deep, injuring large arterial vessels, when the hemorrhoid nucleus is necrotic and falls off, the arterial vessels in the deep trauma are not firmly occluded, and hemorrhage can occur. Injecting sclerotherapy injects a large amount of liquid, the needle penetration is too deep, and when the necrosis falls off, the traumatic surface is too large and deep, injuring the arterial vessels; the ligature area is too large, and when the hemorrhoid nucleus is necrotic and falls off, a large fresh trauma is formed, and if the stool is constipated and defecation is hard, tearing the wound and the arterial vessels, it will cause hemorrhage. Patients who have postoperative infection, the presence of a large number of bacteria in the intestinal tract, infection of the trabecular surface of internal hemorrhoids during the shedding period or wet necrosis of large ligated hemorrhoid nuclei, secondary infection or thrombus shedding, infection erosion of small arteries thus hemorrhage occurs. In addition patients who have systemic diseases, such as patients with abnormal coagulation mechanism or with hypertension, arteriosclerosis, blood system diseases, diabetes, liver cirrhosis, etc., are the basis for postoperative hemorrhage. Drug and dietary factors, intraoperative and postoperative pain medications such as aspirin, anti-inflammatory pain, painkillers and vasodilator drugs can also cause bleeding; postoperative alcohol consumption and spicy and irritating food can cause hemorrhage. If the patient bleeds a lot and is in shock or semi-shock, give fluid or blood transfusion immediately to rapidly expand blood volume and correct shock. At the same time, antibacterial drugs and hemostatic drugs are given to control infection, improve blood clotting and relieve the symptoms of hemorrhage in time. After the patient’s hemorrhagic symptoms have subsided, appropriate care needs to be continued to prevent rebleeding and to help the patient recover more quickly. Therefore understanding the care measures after hemorrhoid haemorrhage can contribute to the success of the surgery as well. 2.How should I care for hemorrhoids after hemorrhoid surgery? Observe whether there is rebleeding After the hemorrhage is controlled, you need to closely observe the patient’s vital signs and whether there is blood and exudate at the wound, and report any abnormalities in time, because the anal sphincter is usually in a contracted state, generally bleeding will not flow out of the anus, and most of the blood goes up to the large intestine, sigmoid colon and other parts of the body, which can cause uncomfortable symptoms such as dizziness, nausea, abdominal distension and shortness of breath, and pay attention to whether there is pallor, fine pulse, and Early bleeding manifestations such as irritability and indifference. Psychological care Patients with massive bleeding are often fearful and anxious. Pay attention to the psychological changes of patients, patiently explain the surgical method and prognosis, and provide comprehensive care to relieve patients’ anxiety and fear. Anti-infection care Follow medical advice accurately, use antibiotics in a timely manner, pay attention to temperature changes, avoid cold food and prevent diarrhea. Minimize the number and amount of bowel movements to reduce wound irritation, wash with warm saline immediately after defecation, change the dressing in time, and keep the wound dressing clean and dry. If the patient has difficulty in urination, observe the degree of bladder filling, use hot towels on the bladder area, listen to the sound of flowing water, frequency spectrum physiotherapy lower and other physical methods to induce urination, if it is not effective, follow the doctor’s instructions to perform retained catheterization. After that, eat light, nutritious and easily absorbed soft food to promote the recovery of tract function. Keep the stool unobstructed Try to control the stool 1-2 days after normal defecation, those who have not relieved the stool for 3 days can use enema with corkage, pay attention to the operation as gentle as possible. Health education Patients need to be strictly bedridden for 24 hours after surgery, and if conditions allow, try to be bedridden for 3 days before getting out of bed for light activities, avoid heavy physical activities for 1 month, avoid too spicy, seafood and thick food, so as not to damage the spleen and stomach, eat more coarse food, drink more water, defecate regularly, do not squat for a long time in the toilet. Develop good lifestyle habits, regular rest and rest, quit smoking and drinking, avoid prolonged sitting, standing and lying down, and work and rest together. The success of a surgery requires the joint efforts of doctors and patients, do not feel “tolerate if you can” because of the fear of hemorrhoid surgery, only correct the mindset when facing the disease, in order to reap good treatment results. Make it clear that no surgery is too big or too small, and seek medical help as soon as discomfort or abnormality occurs to close the “bleeding valve” at the source. References [1] Zhao Jibo. Causes and prevention of postoperative hemorrhoid bleeding [J]. China Medicine Herald,2010,7(01):169+172. [2] Liu Fang. Nursing experience of postoperative haemorrhoid haemorrhage[J]. Journal of practical hospital clinical,2006(05):106