Resume your normal diet. We encourage you to have some roughage with each meal. Avoid hot/spicy foods and beer and wine, as these may cause irritation about the anus. We caution you not to drink alcohol while taking pain medications.
Begin sitz baths the day of surgery – three times daily and after each bowel movement (5-15 minutes of bath water temperature). You may use the tub if the sitz bath itself is uncomfortable. More frequent usage is encouraged if anal discomfort warrants. Make only normal efforts to pass a stool. There may be false urges to defecate after meals, just walk away if nothing happens – the sitz bath is useful if you have these sensations and can help also if you have difficulty urinating. If you cannot urinate and feel uncomfortable, call the office.
Remove the outer dressing tonight. If there is a dressing inside the anus leave it in place. If this dressing is extruding the day after surgery, then it my be removed with a slight “tug” but if it is resistant, then leave it in place as it will dissolve or fall out in the sitz bath.
Take 2 Bisacodyl (laxative) tablets at bedtime – as you were directed
Konsyl or other powders (Citrucel, Metamucil) are bulk laxatives, which increase the volume of stool through colon water retention, and may be started the day after surgery. However, they are effective only if you eat roughage supplied by a proper diet of bran, fruit, vegetables, etc. Konsyl, Metamucil, Citrucel or similar supplements are best taken after a meal. If you are not getting the desired effect, then more attention should be directed towards your intake of fiber. Increasing the dose of Konsyl, Citrucel, or Metamucil beyond one or two teaspoons daily is usually ineffective and will produce a gassy/bloated feeling. If you judge your stool to be too loose or are having more than two bowel movements per day, then cut back on the dose or stop it completely. If you have not had a bowel movement after the third day following surgery, take a Fleet enema or call the office. Pain pills may be taken – one or two every 3-4 hours. These pills are narcotics and there may be a tendency to have dizziness or nausea. There are alternative medications if nausea persists.
Anorectal operations may vary with one, two, three, or more “rows” of stitches, or none at all. The doctor will discuss this with you. If you have stitches they will dissolve. In order for the stitches to dissolve, the tissues about the anus will create an inflammatory reaction, therefore, do not be alarmed by some soreness, bleeding, discharge, or false urges to defecate. Bleeding with the passage of stool is possible up to several weeks following surgery. If the bleeding is heavy and does not stop in a few minutes with gentle pressure (like when you cut yourself shaving), call us immediately. Do not be alarmed by swelling about the anus. These are not hemorrhoids, but simply a swelling due to the stitches. Strenuous exercise and heavy lifting are to be avoided for at least three weeks. You may drive when comfortable.
See below for the date and time of your next appointment. Please call the office if you need to change the appointment. We will answer questions that may arise regarding work, sexual relations, diet, and physical activities. Insurance forms and work release can be handled at the office.
Call the office at (610) 439-9357 if you have any questions or problems during your convalescence.