Hemorrhoid, Sphincterotomy, Rectal/Anal Surgery

Post-Operative Instructions

You will most likely be able to go home accompanied by a responsible adult. If you had general anesthesia, you may feel drowsy or nauseated for a temporary period of time that may last 12 to 24 hours.

After Care

Take a sitz bath (soak in a tub with warm water or use a sitz-bucket purchased in drug stores filled with warm water) for 20 minutes three to four times a day for the next 1 to 2 weeks. This will help with the pain and the healing process.

You may apply witch hazel, Balneol, Vaseline, or Preparation H to the rectal area between baths as needed for dryness or local irritation.

After you have a bowel movement, clean the area with a water-moistened tissue or with a Tucks pad.

Pain, swelling and weeping of the tissues is normal. You can use a sanitary pad to absorb the drainage.

Note that some blood-tinged drainage is normal and you may actually have bleeding for 3 to 7 days after the procedure. Unless bleeding is severe, there should be no worry. Bleeding may also occur 7 to 14 days after treatment when the scab comes off. Spotting is normal; heavy clots need to be reported to our office.

The swollen tissue inside the rectum can often cause a false sensation and an urge to have a bowel movement. This is normal and will improve over the week. If you are having difficulty having bowel movements avoid straining and sitting on the toilet for too long. Do not take enemas for at least 14 days after the procedure. The enema could damage the tissue and cause bleeding.

You may shower any time after surgery.

Your doctor may recommend sphincter exercises later on in the healing process.

Urination

If you are having difficulty urinating after getting home, try running the water in the bathroom. You do not have to force fluids, just drink fluids as you normally would. If you are still unable to urinate after 8 hours and have a feeling of fullness you will need to go to the Emergency Room.

Diet

You may resume a regular diet when you return home, however it is recommended that you eat light, easily digestible food the day of surgery. The next day begin eating plenty of fruits, vegetables, and/or bran flakes and drink plenty of fluids. You should follow a high-fiber diet for life.

Constipation

To avoid constipation drink prune juice. Until the rectal area is completely healed, use a stool bulking agent and a stool softener daily to keep your bowel movements very soft. Examples of bulking agents include Citrucel and Metamucil. Docusate 100 mg once to twice a day is a stool softener. If you have diarrhea you may avoid the stool softener.

You may have a gentle laxative, such as 1-3 tablespoons of Milk of Magnesia if you have not had a bowel movement for two-three days.

Medication

Please be sure to take all medications that you usually take on a regular basis. However, avoid aspirin for five days after your operation, unless prescribed or recommended by your surgeon.

Pain medication may have been prescribed for you; you may take it as needed. You should avoid driving, operating heavy equipment, or potentially hazardous garden equipment while taking narcotics. Side effects of narcotics may include nausea, vomiting, lightheadedness, rash, irritability, or fatigue. Once the pain begins to subside, you may try taking Tylenol since you may not need narcotics. This will help avoid constipation as well.

Activity

You should avoid heavy lifting after surgery. Avoid any kind of straining movements, including straining to have a bowel movement.

Start walking the day of surgery and walk a block or ¼ mile three times a day, increasing the distance every day. Remember: exercise helps prevent constipation.

Many people have problems sleeping after an operation. This is usually the result of too many naps during the daytime. Adequate activity should resolve this problem.

Resumption of driving is dependent on the type of procedure you have had and your level of pain and mobility—generally a few days to up to two weeks after surgery. As always, wait to drive until common sense says it is safe to do so. You must no longer be taking narcotics, and must be able to respond physically and cognitively to any situation on the road you may encounter.

Call the Office at (815) 717-8730

• When you return home to schedule a follow-up appointment for about 2 weeks from surgery.
• If you have excessive bleeding that concerns you.
• If you are still unable to have a bowel movement after trying Milk of Magnesia on the third day following surgery.
• If you develop a fever of 101° F or 38.5° C or higher following the day of surgery.

Go to the Emergency Room:

• If you have been unable to urinate eight hours after being discharged from your surgery and have a feeling of fullness. You may tell the ER physician that you need a Foley catheter placed and will follow-up in our office the next business day.
• If you have serious problems and are unable to reach your surgeon or office staff.

If you need FMLA forms completed, fax them to 815-717-8729 or you can mail or drop them off at the office.