Hemorrhoidectomy

Hemorrhoids are swollen veins inside or outside the anus. They may be caused by increased pressure, such as straining when having a bowel movement or pregnancy. Hemorrhoids can cause pain, bleeding, swelling, and itching. This handout tells you how to care for yourself after they are removed.

After Surgery

Rectal Care

Take a sitz bath at least three to four times a day and after each bowel movement for several days. Sit in bathtub filled with 3-5 inches of warm water for at least 10-20 minutes. Do not add anything to the water or use a sitz bath unit that fits over your toilet.

Sitz baths help you heal and lessen the pain of local spasms. For comfort, you may want to sit on a towel in your bathtub.

Avoid toilet paper. Instead, spray the area with warm water after a bowel movement. We will give you a spray bottle. You may want to use a handheld shower, or gently pat dry with a baby wipe, (free of perfume, dyes, and alcohol).

You will have yellow-red drainage for at least 7-14 days. Wear pads (free of perfume and dyes) in cotton underwear (use dye and fragrance-free detergent) to monitor drainage. Change pads every 4 hours or as needed to limit wetness and prevent itching.

You may see more bloody drainage as you have bowel movements and become more active. You may have swelling at the anus with tissue sticking out from anus. You may also have a lump or skin tags grow around the anus. This is your body’s reaction to the incisions made at surgery. These lumps will shrink as you heal.

Activity

• Plan for rest during the day. Expect to be up and around doing light duties each day to keep up your strength.

• Change positions often for comfort.

• No driving while taking opioid pain pills.

• You may resume sex when your doctor says it is okay.

• Check with your doctor before you return to work. You may be out of work longer if your job involves lifting or sitting.
  

Pain

After surgery, you will have pain. At first, you will feel numb in your rectal area. Take your pain pills before you have pain and take them on a schedule for at least the first 1-2 days to stay ahead of the pain. Taking acetaminophen (Tylenol®) and ibuprofen throughout the day helps keep the pain at a lower level.

The first 5 days you will have a lot of pain. Expect to have pain with your first bowel movement. Do not hold off on having a bowel movement. Follow the urge to go when you feel it.

If you had banding, the bands fall off in 3-10 days. You may bleed and have more pain at that time.

If you have stitches, they dissolve in 10-14 days. You may bleed and have more pain at that time.

After 5 days you may have less pain. It is normal to see blood on your stool for weeks after surgery.

Avoid Constipation

Buy the stool softener, docusate sodium. Take at least 2 each day. Take these if you use the opioid pain pills and until you have your first bowel movement. This will help stool pass more easily. Follow package directions.

Buy a bulk fiber laxative, such as Metamucil®. If taken every day, it can prevent hard stools. Follow package directions. Do not start until after your first bowel movement.

Drink at least 8 glasses (8 ounces each) of fluid each day. This helps you heal faster, helps your pain pills work better and can help prevent constipation. Drink enough fluid so that the color of your urine is light yellow or clear.

Diet

You may want to eat a soft or liquid diet until you have your first bowel movement, though this not required after surgery. Avoid spicy and acidic foods as you heal.

When to Call

• Large amounts of bright red blood from the rectal area that does not stop with firm pressure to the rectal area for 10 minutes

• Fever over 100.4° F

• Foul-smelling drainage

• Excess swelling in the rectal area

• Problems passing urine
  

Who to Call

Digestive Health Center

(608) 242-2800 or (855) 342-9900

After hours, weekends or holidays this number will be answered by the paging operator. Leave your name and phone number with area code. The doctor will call you back.