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, clots, and itching.

 

Before Surgery

 

Buy these products at your local drugstore.

• 1 bottle (10 ounce) of Magnesium Citrate
• 2 sodium phosphate enemas

The Day before Surgery

• Eat a light breakfast and lunch.  Avoid greasy foods and red meat.
• Drink only clear liquids after lunch up until midnight.  There is no limit on the amount.

Water	Clear Jell-O® ( no fruit in it)
Broth	Sparkling water or soda
Juice with NO pulp (apple, grape)	Coffee or tea (no creamer)
Popsicles®	Gatorade®
Hard candy	Boost Breeze®

• At 2 pm, drink at least 5 ounces of the Magnesium Citrate (½ bottle).  You may want to drink the whole bottle if you are constipated.

The Day of Surgery

• 1½ hours before you leave home, give yourself the first enema.
• 1 hour before leaving home, give yourself the second enema.
• Shower.

After Surgery

 

Rectal Care

Take a sitz bath at least three to four times a day and after each bowel movement for several days.  This can be done in two ways.  Sit in a tub of water filled 3-5 inches with warm water for at least 10-20 minutes or use a plastic tub that you place in your toilet. Sitz baths help with healing and  lessen pain and rectal spasms.

 

Avoid using toilet paper for the first few days.  Instead clean the anal area after a bowel movement by spraying area with warm water.  We will give you a spray bottle.  Gently wipe with an alcohol-free baby wipe.

 

You will have yellow-red drainage from the rectum for at least 7 to 14 days.  You will need to wear pads in your underwear.  The drainage will decrease in amount and become lighter in color over time.  You may notice an increase in bloody drainage with increased activity and bowel movements.

Activities

• Plan for rest during the day.  Plan also to be up and around doing light duties each day to maintain your strength.
• Avoid sitting or standing for longer than 1 hour for the first few days.
• Do not lift more than 10 pounds for 6 weeks.
• For safety reasons, do not drive for 2 weeks.  Do not drive as long as you are taking narcotic pain pills.
• Sex may be resumed when it is okayed by your doctor.
• Check with your doctor before you return to work.  Your recovery time may be longer if your job involves heavy labor or sitting for long periods of time.

Pain Medicine

After surgery, you will have pain.  Your rectal area will be numb so you may be able to get home without narcotic pain medicine.  Your doctor will order pain pills for you.

 

For the first 24 hours, you may need to schedule your pain pills every 4-6 hours.  The person staying with you overnight will need to set an alarm and give you your pills with a snack.  It is very important that the pain does not wake you up in the middle of the night.  Stay ahead of the pain for the first few days, and do not let your pain get out of hand.  Do not drink alcohol, drive a car, or use heavy machines while you are taking pain pills.

 

You may expect your pain to follow this scenario.

• The first 5 days you will have a lot of pain.
• The 4^th or 5^th day you may have a bowel movement without too much pain.
• If you had banding, the bands will come off.  You will see more bleeding and have more pain.  You may need narcotic pain pills again.
• If you had sutures, they will dissolve in 10 to 14 days.  You will see more blood and have more pain.  You may need narcotic pain pills again.
• You should begin to have less pain.  You can sill have blood on your stool for several weeks after this.

 

Constipation

To avoid constipation, take docusate sodium. While you are taking pain pills every 4-6 hours take the stool softener at least twice a day.  This will help stool pass more easily.  You may also take a bulk fiber laxative like Metamucil® to prevent hard stools.  Follow package directions.  Drink at least 8 glasses (8 ounces each) of fluid daily to help prevent constipation.

Diet

You may want to eat a soft or liquid diet until you have your first bowel movement.  To prevent straining and constipation, eat a diet high in fiber and drink plenty of fluids.

When to Call the Doctor

• Large amounts of bright red blood from the rectal area that will not stop with firm pressure to the rectal area for 10 minutes.
• Temperature greater than 100.4° F.  Take your temperature daily for one week.
• Foul-smelling drainage.
• Breaking open of suture line.
• Excess swelling in the rectal area.
• Problems passing urine.

Phone Numbers

 

Surgery Clinic, Monday - Friday, 8: 00- 4:30:  (608) 263-7502.

 

After hours, weekends, or holidays:  Ask for the General Surgery resident on call with Dr. ________________________________________.
Leave your name and phone number with the area code.  The doctor will call you back.

 

Toll Free:  1-800-323-8942.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 12/11/2009

Copyright © 12/11/2009 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #4461

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