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Hemorrhoidectomy

Diet
You may begin eating and drinking as soon as you get home from surgery. You may eat a regular diet as tolerated. It is very important to avoid constipation during the recovery period. Therefore, you will be placed on a high fiber diet or should take a fiber supplement such as Metamucil or FiberCon. You should also drink plenty of liquids.

Activity
As soon as you reach home, you may resume normal ad lib activity. You are encouraged to begin walking and resuming household activity as tolerated immediately. Going up and down stairs is also Ok.You should refrain from engaging in any strenuous activity such as running, riding a bike, heavy exercising in a gym, etc. for at least 2-3 weeks. You should also avoid any heavy lifting greater than 20lbs. for 2-3 weeks. After that, you may resume any activity as tolerated. Most people return to work within a week after surgery, but complete recovery can take 6 weeks to 2 months.

Wound Care
You will have a gauze dressing around your anus after surgery. This can usually be removed by the following day and left off. An ice pack can help reduce swelling. Soaking in a sitz bath (a shallow bath of warm water) several times a day helps ease the discomfort. Using a donut ring (cushion with a hole in the middle) can make sitting upright more comfortable. A small to moderate amount of bleeding, usually when having a bowel movement, may occur for a week or two following the surgery. This is normal and should stop when the anus and rectum heal. If there is any excessive pain, bleeding, swelling, green/white drainage, or fever, please call your surgeon immediately.

Medications
You may resume all your normal medications after surgery except for aspirin or other anticoagulants. You should wait at least 1 week after surgery before beginning aspirin or other anticoagulants. You may need to wait longer, but please consult your surgeon first.

Pain Control
You will experience the most intense pain for several days after the surgery. It may last up to 10 days after the surgery. You will still be sore after that for up to 3-4 weeks after the surgery. You will most likely be sent home with a prescription for narcotic pain medications. Use the narcotics as directed on the prescription. You may take less than what is indicated on the bottle, but not more. Be sure to take narcotic pain medication with food so as not to upset your stomach. You may begin to taper your narcotic medication as tolerated and discontinue them as soon as possible. As you are tapering off the narcotics, you may transition over to Ibuprofen. You should not drive or operate any mechanical equipment while on narcotic medications. Wait for at least 24 hours after discontinuing the narcotic medications before driving.

Bowel Movements/Urination
It is not unusual for patients who have been through surgery, a general anesthesia, and who are taking narcotics to become constipated. It is very important after a hemorrhoid surgery to avoid constipation. You will be sent home on a high-fiber and high liquid diet. You will also be sent home on stool softeners such as Colace or Sennekot. If you need something more than this to avoid constipation, you may need to take over-the-counter oral laxatives such as Milk of Magnesia or Magnesium Citrate. You should stay away from rectal suppositories or laxatives. You should stay regular and have a soft bowel movement every day. If none of these measures work or if you begin to have significant abdominal pain, nausea/vomiting, diarrhea, or bleeding, please contact your surgeon immediately.

Because of swelling and the dressing, some patients have temporary difficulty urinating. If there is urgency, but the urine will not flow, a catheter is used to empty the bladder. Outpatients may need to stay overnight, if they are unable to urinate. Patients must be able to urinate on their own before being discharged.

Follow-Up Visit
You will be instructed as to when you should return to the office on your discharge instructions. The exact date will either be scheduled for you before you leave the surgery center, or you will be instructed to call the office to schedule this. You will usually be seen again approximately 2 weeks after the surgery.

Further Information
Hemorrhoids – from the American Society of Colon & Rectal Surgeons
Anal Abscess/Fistula – from the American Society of Colon & Rectal Surgeons
Anal Fissure – from the American Society of Colon & Rectal Surgeons
Pilonidal Disease – from the American Society of Colon & Rectal Surgeons
Hemorrhoidectomy Surgery – from About.com Surgery
Anal Fistulotomy Surgery – from emedicine.medscape.com
Anal Sphincterotomy Surgery – from emedicinehealth.com
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