Post Operative care post Anorectal Surgery

Information for:

  • HAEMORRHOIDECTOMY
  • FISTULOTOMY
  • LATERAL SPHINCTEROTOMY
  • PER ANAL DELORME
  • ANAL SPHINCTER REPAIR

What to expect after your operation

Immediately after your procedure you will spend ½ to 1 hour in the Recovery Area. Here you will be monitored as you wake from anaesthesia and you will be given any pain relief you may need.

When you are awake and comfortable you will be moved back to your bed in the ward (if you are to stay overnight) or to the Day Surgery recovery area until you are ready to go home.

 

Over the next few days…

Your wound:

You will usually have a pad over your bottom and a small dressing in your anal canal. This dressing is used to stop any bleeding after surgery and is made of a material that dissolves. It often falls out when you first go to the toilet or have a bath. Don’t worry – this is what it is supposed to do. It does not need to be specially removed.

Over the next few days you may have a small amount of ooze from your back passage and wearing a pad will prevent soiling your clothes.

Any stitches you have will automatically dissolve. The time these take to dissolve depends on the type of stitches used by your surgeon. You may be able to feel stitches at the end of your excision and they may feel like fishing line. This is perfectly normal but be sure not to pull on these.

Pain Relief:

Any operation causes some discomfort while your body heals. The first 48 hours will be the most uncomfortable and taking regular pain relief will make things more comfortable for you. You may be given a prescription for pain relief as you leave hospital. Use these as directed.

If you haven’t been given a prescription upon discharge from hospital, pain relief in the form of Paracetamol (e.g. Panadol) is normally sufficient. If your pain is not relieved by either Paracetamol or your prescription medication, taking some practical steps to relax is worthwhile. Simply having a lie down, listening to relaxing music or having a saltwater (or Sitz) bath can give relief.

Pain relief medication to Avoid:

  • Aspirin – it may cause continuing bleeding from your wound.
  • Codeine – it tends to cause constipation. It is often found with Paracetamol in painkillers (e.g. Panadeine.

 

Saltwater or Sitz Baths

This involves dissolving ½ cup of salt in a few inches of warm water in the bathtub and letting yourself soak in the warmth for 10-20 minutes. This keeps your wound clean and often makes it feel better. You should have a Sitz bath three times a day for the first seven days following your procedure.

 

Going to the toilet afterwards:

Most people feel some concern at the thought of moving their bowels after having a procedure involving their bottom. Avoiding constipation is a good idea and will make going to the toilet much more comfortable.

To prevent constipation the following will help:

  • Drinking lots of water (8 glasses a day is recommended)
  • Doing some gentle exercise (walking around the home)
  • Drinking and eating foods that you know will help move things along (e.g. orange juice, pear juice, liquorice, prunes).
  • Adding Metamucil (1-2 teaspoons daily) or another fibre supplement to your diet.
  • Be guided by advice from your surgeon or the hospital staff.
  • When it comes to actually going to the toilet remember:
  • Don’t go until you really need to.
  • Don’t strain. Straining will cause the tissues around the site of your operation to swell and you will feel more uncomfortable.
  • Don’t keep going back to the toilet and sitting – this also adds pressure and increases swelling.
  • If your bottom is painful, consider some Panadol or a saltwater bath to help you feel better.

 

Over the next few weeks…

Energy Levels

Remember – you’ve had an operation. Be gentle on yourself and don’t be surprised if it takes some time for your energy levels to get back to normal. The more involved your operation then the longer it will take to feel 100%.

Healing

It takes 4-6 weeks to fully heal the tissues at your operation site – hence the reason your surgeon will generally see you for your post-operative appointment 4-6 weeks after your procedure. As with energy levels, the larger the operation, then the longer it will take for your back passage to feel normal. Looking after your diet to prevent constipation and taking any medication your surgeon has recommended will make things go much more smoothly. A small amount of blood on the toilet paper is common for many patients and is not a cause for concern, even 2-3 weeks after your procedure.

Exercise

Many people exercise strenuously and regularly e.g. going to the gym or running. Ask your surgeon if you need to limit the activity you would normally enjoy. Gym work, running etc. can put excessive strain on healing tissues and jeopardise the success of your procedure.