The information below will help you understand what will happen and what to expect for the first few days after surgery. Following these guidelines will help you heal from your surgery as quickly as possible and may reduce the risk of some complications.
Please Review These Instructions Carefully
- Pain is normal following anorectal surgery and can last 2 weeks or longer.
- To decrease pain – take your pain medication as directed and use a stool softener or fiber supplement. It is important not to allow yourself to become constipated. (see below for more information)
- Sitz baths, warm tub soaks, or showers 2-3 times a day and after bowel movements will reduce pain and keep the area clean.
- Applying an ice pack for 15-20 minutes several times a day can help reduce inflammation and pain around your incision.
- Applying a warm pack or heating pad can sooth the area and provide pain relief.
- Allow your skin to return to its normal color and temperature before reapplying ice or heat.
- Your doctor may prescribe Lidocaine, a topical medication applied locally to reduce pain.
- Anti-inflammatory medications (NSAID’s) such as Motrin®, Advil® and Aleve® can improve the effectiveness of narcotic pain medications or replace them altogether. (See warning below under pain medication regarding use of NSAID’s)
You will be prescribed a narcotic pain medication (Percocet, Norco), take this every 4-6 hours as needed for pain. Narcotic pain medications and may impair your ability to think clearly. Please do not drive, operate machinery or drink alcoholic beverages while on this medication.
As you heal and your pain decreases you should transition to over the counter pain medications. We recommend one of the following:
- Acetaminophen (Tylenol®) may be taken for mild to moderate pain. Do not take with Percocet® or Norco®, or other medications like them that contain acetaminophen. Taking more than 4,000mg of acetaminophen within 24 hours may cause serious liver damage. Do not take acetaminophen if you have liver disease.
- Ibuprofen (ex. Motrin®) 600 mg, can be taken every 6 hours with food. Check with your doctor before taking NSAID’s if you have kidney disease, liver disease, an active bleeding disorder or have been advised by your primary care provider to avoid using anti-inflammatory medications.
Caring for your Incision
- You may notice the passage of small amounts of blood and mucous, this is normal. Keep a gauze pad tucked between your buttocks to collect any drainage. Change the pad when it becomes damp.
- Dry Toilet paper may irritate your skin. You may want to use wet toilet paper, a peri bottle, shower or sitz bath to clean the area after bowel movements.
- You may experience pain or discomfort with bowel movements. This is normal and will decrease over time.
- Begin every day with 1 tablespoon of Metamucil®, Citrucel®, or Konsyl® mixed in water or juice. If necessary take an additional tablespoon at noon. These are fiber supplements that bulk up and soften the stool to ease the passage of bowel movements. Fiber wafers, chewable tablets and capsules are not as effective, so we recommend that you use powder.
- Drink 8-10 glasses of water every day. Avoid caffeine and alcohol.
- If you have not had a bowel movement within 48 hours (2 days) of your surgery it is OK to use an over the counter mild laxative such as Milk of Magnesia or glycolax (Miralax®) as directed on the package. If the laxative is not effective within another 24 hours, call the office.
- Your doctor may prescribe an over the counter stool softener such as Colace®, take this as directed on the package. Kondremul® a mineral oil based laxative may also be prescribed, take 1 Tablespoon twice a day. Take these as directed - discontinue use of you experience diarrhea.
- You may resume your regular diet as tolerated, making sure to include high fiber foods.
- Consume 25-30 grams of fiber a day, including supplements.
- Stay well hydrated by drinking 8-10 glasses of water a day.
- No strenuous activity or lifting more than 10 pounds for 2 weeks unless told otherwise by your surgeon.
- It is ok to walk, climb stairs, ride as a passenger in a car, and perform normal activities of daily living.
- Unless otherwise instructed, you may return to work as tolerated.
- Do not drive or operate heavy machinery if taking narcotic pain medication.
- Check with your surgeon before resuming sexual activity.
- Ensure you have a follow up appointment with your surgeon for 4 weeks from the date of your surgery.
- If this appointment has not been scheduled please call the office (415) 885-3606 as soon as possible after your surgery.
If you experience any of the following call the surgeon’s office: (415) 885-3606
- Temperature of 101.5° F or greater
- Shaking chills
- Nausea and vomiting
- Severe pain that is not relieved by your prescription pain medication
- No bowel movement for 48 hours, even though you have taken a laxative
- Difficulty urinating or no urine output for more than 8 hours
- Increased swelling or redness around the rectum
- Excessive bleeding - more than 1/2 cup and it continues
*** Please call 911 if you develop chest pain, sudden shortness of breath, fainting, and/or loss of consciousness.