Most
anorectal surgical procedures are done
in same-day surgery. A few more extensive
procedures require hospitalization for
one to three days. Your ability to tolerate
the pain postoperatively and your doctor's
concern about your wounds determine the
time of discharge.
After
Discharge
Medicines
You will take home
1.
A prescription for pain medication
with instructions. If you need additional
medication, call your doctor during
normal business hours. (After hours,
if the doctor on call does not know
you personally, he or she may not
renew narcotic pain medication by
telephone.) 2. Bulk-forming stool
softeners (for example, Konsyl®,
Metamucil®, or Citrucel®)
to be taken in a glass of water two
or three times a day. 3. Anal ointment,
such as Americaine®, Tronothane®,
or Xylocaine®. Apply these ointments
to the anal area with your finger;
then cover with cotton or gauze.
Bowel
Function
Bowel movements after anorectal surgery
are usually associated with moderate
to severe discomfort. Constipation
and diarrhea make the pain much worse
and must be avoided. The trauma to
the anal wounds caused by hard bowel
movements will slow down the healing
process.
Constipation
You should be sure to have a bowel
movement at least every other day.
If two days pass without one, take
an ounce of milk of magnesia; if
there is no result, repeat this
dose in six hours. You can also
use an over-the-counter phosphate
enema or tap water enema.
Diarrhea
Diarrhea, usually caused by overuse
of laxatives, is also a concern
if you have more than three watery
bowel movements during a 24-hour
period. If diarrhea occurs, stop
taking milk of magnesia or other
laxatives. Continue the bulk-forming
agents. If the diarrhea persists,
call your physician.
Bathing
After bowel movements, use a wet wash
cloth, toilet paper, cotton, or
perianal pads (Tucks, Preparation
H pads) to clean yourself. If possible,
take a sitz bath or tub bath immediately.
Baths should last at least 10 to
15 minutes with the water as warm
as you can comfortably tolerate.
Try to take at least three baths
(or showers with a hand-held sprayer)
a day.
Discharge/Infection
Some bloody discharge after bowel movements
is normal for at least two to four
weeks after rectal surgery. If
you have profuse, continuing bleeding,
call your doctor immediately. Postoperative
infection around the rectal opening
is surprisingly uncommon despite
the obvious contamination by stool.
This is probably because of the
very excellent blood supply to
the area.
Urination
If you have trouble urinating, do so
while sitting in a warm tub of
water, or run the water faucet
while sitting on the toilet. If
the problem is severe or persistent,
your doctor may prescribe oral
bladder stimulants.
Diet
Eat a high-fiber general diet, including
plenty of fruits and vegetables.
Try to drink at least six to eight
glasses of water or juice per day
to help keep the stool soft.
Activity
On discharge there are generally no
restrictions on walking, climbing stairs,
or riding in a car. After some procedures
you will be asked to avoid strenuous
activity or heavy lifting for 7 to
14 days.
Causes
for Concern
If
any of the following occur, please call
our office and speak with the nurse.
She will help you with your problem or
have the doctor call you.
- Problems
with the incision(s), including
increasing pain, swelling, redness,
or drainage
- Severe
constipation (no bowel movement
for three days)
- Diarrhea
(more than three watery stools
within 24 hours)
- Difficulty
urinating
- Fever
greater than 101 degrees
- Severe
bleeding
- Nausea
or vomiting
- Chills
If
your doctor is not available, a doctor
on call is available 24 hours a day,
every day of the year. After hours, call
any of our offices and the answering
service will locate one of our doctors
on call. In an emergency, try to contact
us for advice before you go to the hospital.
A telephone call may save you a lot of
time, discomfort, and expense. |
