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Post Operative Instructions for Anorectal surgery

Please read theses instructions very carefully. Follow the instructions as closely as possible. If you have any questions, please do not hesitate to call the office at 212-523-8172.


Wound Care


Starting the morning after your surgery, you should begin taking “Sitz Baths”. Sitz baths increase the blood circulation in your anal area, which will help the healing process and make you feel more comfortable. This should be done at least three times a day and after each bowl movement.


A plastic basin for these baths may have been given to you when you left the hospital. If not they can be purchased in any drug store or your regular bathtub the tub will suffice. Each sitz bath should last about 15 minutes.


After the bath, carefully pat your bottom dry do not rub. It will also help to place a gauze pad over (not inside) your anus after these baths, or you may also use a sanitary napkin to protect your underwear and absorb discharge.


Pain Medication


Most patients experience significant pain at some point after anorectal surgery. This is to be expected. Sitz baths provide much relief from the pain and can be taken frequently to help relieve the discomfort. However, pain medication is also needed fro most patients. After the first week, you should only need .


You will be given 2 prescriptions for pain medications.


  • The first is for Toradol (ketolorac), which you will take for 3 days (1 pill four times a day). This medication is not a narcotic. However, it can cause stomach problems if taken for a long period of time. , you will only be given a 3 day supply. It is best if this medication is taken around the clock for the first 3 days.
  • The second prescription is for a narcotic. You will take 1-2 tablets every 4-6 hours only if you have significant pain. DO NOT TAKE THE NARCOTIC EVERY 4 HOURS AUTOMATICALLY. If the Toradol alone is not sufficient during the first 3 days after surgery, you can take 1 or 2 of the narcotic containing pills. If you are comfortable do not take theses pain pills, even if it has been many hours since you took the last one. You should not drive a vehicle or drink alcohol while taking pills containing narcotics.

Antibiotics


You will also be given a prescription for an antibiotic called Flagyl (Metronidazole). This is to be taken 3 times a day for the first 3 days following your surgery. This medication is an antibiotic; however, it has been shown to help decrease the severity of pain.


Stool Softeners


It is very important to follow the following regime after your operation to keep your stools soft, bulky and easier to pass. These medications are easily obtainable and do not require a prescription:

  • Ducosate sodium (colace) 100mg capsules 1 pill 4 times a day.
  • Fiber supplement (Citrucel/benefiber/Metamucil) at least 1 tablespoon in an 8 ounce glass of water a day (if the stool remains hard, a second dose may be taken).
  • Mineral Oil (laxative) 1 tablespoon a day. After the first 2 weeks, the mineral oil should be discontinued.

After the first two weeks the mineral oil should be stopped. You may continue taking the Ducosate sodium and the fiber supplement as long as you like. Neither medication is harmful and both can be taken safely for an indefinite period of time.


First Bowel Movement


It is important that you do not get constipated after your surgery. If you do not have a bowel movement by the third day you should take a mild laxative 3 tablespoons of milk of magnesia. If you do not have a bowel movement within 12 hours of taking the first dose, take another 3 tablespoons of milk of magnesia. If you still haven’t been able to pass a bowel movement for another 12 hours after the second dose, drink 8 ounce bottle of Magnesium citrate. Both of theses items can be purchased over the counter at your local pharmacy.


If this is ineffective after 12 hours, call the office to speak with the Nurse Practitioner. Under no circumstances should you take a suppository or enema. It is important that nothing be placed in the rectum for at least 1 month after surgery.


Rectal Bleeding


There will most likely be some blood or blood clot in one or more of your bowel movements during the first 2 weeks after surgery. This should not alarm you as long as you are only passing small amounts of blood. If you are passing large quantities of blood at any time call the office to speak with one of us as soon as possible.


Difficulty Urinating


Some patients have difficulty urinating the first couple of days after surgery. If you are unable to pass a normal amount of urine or if you are urinating small amounts frequently and feel the sensation of urgency (needing to urinate) call the office to speak with us.