Understanding Rectal Bleeding Post-DIEP Flap Surgery
I am a 50-year-old female, a survivor of breast cancer DCIS, residing in the southwestern United States. I maintain a non-smoking lifestyle and stand 5'10" tall, weighing 190 pounds. Currently, I am under treatment with fluoxetine, omeprazole, cyclobenzaprine, iron supplements, and medications for allergies. My physical activity is somewhat limited as I am still recovering from my surgical procedure; however, I make an effort to walk regularly as part of my healing process. I underwent DIEP flap surgery on November 21, and since that date, I've noticed some spotting of blood on toilet paper and a small amount in my underwear. Being menopausal, I was using vaginal estradiol, but I discontinued it two weeks prior to my surgery and have yet to resume its use. After careful observation, I can confirm that this is not vaginal bleeding, but rather rectal in nature. From my research, I've found that this occurrence lacks rarity following such surgical interventions; however, the duration and necessary actions to take are not well-defined. There are no accompanying symptoms, such as fever, aches, or swelling, and I was prescribed a second course of antibiotics after surgery due to an infection at the drain site. Although my procedure did not involve muscle manipulation, there is a mesh placed between the skin and fascia in my abdomen. Currently, I have one surgical drain left, reduced from four, and it will remain for three additional days. I also have a hemorrhoid that has never previously caused any issues, and my bowel movements are regular and not painful. I have an upcoming appointment with my plastic surgeon on Friday, where I intend to discuss this matter further. However, I am curious if there are any specific questions or symptoms I should monitor in the meantime.
Answers (1)
12/16/2025, 10:40:38 PM
OpenHealth AI
It’s understandable to feel concerned about rectal bleeding after your surgery, especially as a breast cancer survivor and with various factors at play in your recovery. While some degree of spotting can occur post-surgery, especially involving abdominal procedures, it’s important to monitor the situation closely.
Explanation:
Rectal bleeding following DIEP flap surgery may not be uncommon, particularly if there are changes in pressure in the abdominal area or if there’s a history of hemorrhoids. Given your recent surgery and the presence of a hemorrhoid, it's possible that this could be the source of the bleeding. Since you’ve mentioned experiencing no other concerning symptoms like fever or severe pain, that is a positive sign. However, it’s crucial to stay vigilant.
Next Steps:
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Monitor Symptoms: Keep a close eye on the amount of blood and any changes. Important details to note include:
- The frequency and quantity of bleeding.
- Any changes to your bowel habits or pain during bowel movements.
- Signs of infection (increased redness, warmth, and swelling around the drain site).
- New symptoms such as severe abdominal pain, dizziness, or increased fatigue.
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Keep a Diary: Document when you notice bleeding, including anything you might have done around that time (like physical activities or specific dietary changes) that might contribute to it.
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Prepare for Your Appointment: List down any specific questions you want to ask your plastic surgeon:
- Could the bleeding be related to the surgical procedure?
- Should we further evaluate the hemorrhoid as a potential cause?
- What signs of complications should I watch for during my recovery?
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Self-Care: In the meantime, ensure you maintain hydration and a high-fiber diet to support regularity and reduce straining during bowel movements, which can aggravate hemorrhoids. Gentle physical activity, like walking, is great, but listen to your body and don’t overdo it.
By systematically observing your symptoms and being well-prepared for your surgical follow-up, you will help facilitate a thorough evaluation. It’s great you’re taking proactive steps in your recovery, and discussing all these points with your surgeon will further guide your care. Let me know if you have more questions!
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