Understanding Rectal Bleeding Following DIEP Flap Surgery: Key Insights
As a 50-year-old female breast cancer survivor with a diagnosis of DCIS, residing in the southwestern United States, I want to share some personal details. I have not engaged in smoking, am 5'10” tall, weigh 190 lbs, and am on medications including fluoxetine, omeprazole, cyclobenzaprine, iron supplements, and allergy medications. While my activity levels are not high due to recovery from recent surgery, I am doing my best to incorporate regular walks into my routine. I underwent a DIEP flap surgery on November 21. Since that day, I've noticed some spotting blood on toilet paper and a minimal amount in my underwear. Being menopausal, I was on vaginal estradiol but discontinued it two weeks before my surgery and have yet to resume it. Therefore, I confirmed that the spotting is of rectal origin, not vaginal. I understand it’s not entirely uncommon to experience this symptom post-surgery, but I find myself uncertain about the duration it might persist and the actions I might need to take. This bleeding is not accompanied by any other symptoms such as fever, body aches, or swelling. After my surgery, I did undergo a second round of antibiotics due to an infection at the drain site, but my procedure did not involve muscle dissection; there is a mesh implant positioned between the skin and fascia of my abdomen. I currently have one surgical drain left (down from four) that I will keep in place for three more days. Additionally, I have a hemorrhoid which has typically not posed any problems, and my bowel movements remain regular and not strained. I have an appointment with my plastic surgeon slated for Friday, where I intend to inquire about my symptoms. However, I am curious if there are any specific questions or observations I should be mindful of before that visit.
Answers (1)
12/17/2025, 2:30:44 AM
OpenHealth AI
Thank you for sharing your situation, and I appreciate how detailed you’ve been. Your experience following DIEP flap surgery is important, and it's completely understandable to have concerns about the rectal bleeding you're noticing. Here's a structured overview that can help address your needs.
Main Points:
- Spotting blood post-surgery can be common, but it’s essential to monitor the situation carefully.
- You should observe for any changes or concerning symptoms before your upcoming appointment.
Explanation:
After DIEP flap surgery, some individuals may experience rectal bleeding due to several factors, including stress on the body during surgery, medication effects, or existing conditions like hemorrhoids. Since you've had a recent infection and are on various medications, these factors could also play a role. It's reassuring to note that you are not experiencing other worrying symptoms like fever or severe pain.
Hemorrhoids, which you mentioned, can also cause rectal bleeding, especially if you’ve had any changes in bowel habits or increased straining. Since your bowel movements have been regular and unstrained, it’s a positive sign.
Prioritized Next Steps:
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Document Your Symptoms: Keep a brief diary of when you notice the bleeding, how much you see, and any changes in your bowel movements. This can provide valuable information for your surgeon.
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Monitor for Additional Symptoms: Watch for any new symptoms that might arise, such as sudden increases in bleeding, pain, or changes in bowel habits.
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Prepare Your Questions: Before your appointment, consider asking:
- What could be causing the rectal bleeding at this stage of recovery?
- Is the ongoing use of fluoxetine or any other medication contributing to this issue?
- Should I make any dietary or lifestyle changes to alleviate this symptom?
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Review Your Hemorrhoid Status: Mention your hemorrhoid and any previous issues with it during your appointment. This could be significant in addressing the rectal bleeding.
Remaining active, as you are with your walks, can also aid recovery. Continue prioritizing hydration and a diet high in fiber to help with regular bowel movements and potentially relieve any discomfort related to hemorrhoids.
It's great that you have an appointment soon to discuss your symptoms further. Maintaining communication with your healthcare team is essential for a smooth recovery. If your bleeding worsens or you develop new concerning symptoms like severe pain, it would be appropriate to seek urgent advice.
Take good care, and stay tuned for your follow-up appointment. Let me know if you have further questions!
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