Which statement about analgesia after hemorrhoidectomy is correct?

Which statement about analgesia after hemorrhoidectomy is correct?

• A. Opioids worsen constipation after hemorrhoidectomy
• B. NSAIDs worsen constipation after hemorrhoidectomy
• C. Both worsen constipation after hemorrhoidectomy
• D. Neither affects constipation after hemorrhoidectomy

Answer: (A)

Opioid-induced constipation is the key issue. Opioids slow gut motility by activating mu receptors in the gastrointestinal tract, which reduces propulsive movements and increases water absorption. The result is harder stools and a higher risk of painful, difficult defecation. After hemorrhoidectomy, defecation is already painful and healing sites are sensitive to strain; adding opioid-related constipation creates a cycle of withholding stool, worsening stool hardness, delaying healing, and increasing discomfort. Because of this, minimizing opioid use and leveraging other pain-relief strategies helps protect bowel function after surgery. Nonopioid analgesics such as acetaminophen or NSAIDs (when appropriate) and regional or local anesthesia can provide effective pain control with less impact on the bowels. Complementary measures like stool softeners and adequate hydration support easier, less painful bowel movements during recovery.

Opioid-induced constipation is the key issue. Opioids slow gut motility by activating mu receptors in the gastrointestinal tract, which reduces propulsive movements and increases water absorption. The result is harder stools and a higher risk of painful, difficult defecation. After hemorrhoidectomy, defecation is already painful and healing sites are sensitive to strain; adding opioid-related constipation creates a cycle of withholding stool, worsening stool hardness, delaying healing, and increasing discomfort.

Because of this, minimizing opioid use and leveraging other pain-relief strategies helps protect bowel function after surgery. Nonopioid analgesics such as acetaminophen or NSAIDs (when appropriate) and regional or local anesthesia can provide effective pain control with less impact on the bowels. Complementary measures like stool softeners and adequate hydration support easier, less painful bowel movements during recovery.