Pre-operative Preparation for a Stapled Haemorrhoidectomy procedure
A stapled haemorrhoidectomy is performed under general anaesthesia as a day case. The principle of the operation is to remove a cylinder of haemorrhoidal tissue approximately 2-3cm in height. The two cuts are then stapled together leaving a staple line approximately 3-4cm in.
Post-operative Care following a Stapled Haemorrhoidectomy procedure
Following your procedure there are a number of things of which you need to be aware.
There are no dietary restrictions after a haemorrhoidectomy but if you feel sick sip water only or contact your surgeon. It is recommended that you drink at least 2-3L of water a day and avoid any food you know may upset your stomach.
It is inevitable that you will experience some discomfort following your surgery. Long acting local anaesthetic will have been injected into the operation site but this will wear off after a few hours. Before it wears off it is important to have some painkillers onboard so please take these soon after arriving home and continue taking them on a regular basis, especially during the first 48 hours. As your level of discomfort eases with time then these only need to be taken as required. You will be given either the tablets to take home or a prescription for Panadeine Forte or Nurofen. Take these as directed on the packet and do not exceed the dose.
You cannot stop your bowel from working and it is important that you resume a regular bowel habit as before. There is a tendency towards constipation so make sure you drink plenty of water in the immediate post operative period and a fibre supplement such as Metamucil, Mucilax or Normocol (available from your pharmacy without prescription). You will also be given a prescription for Coloxyl which is a stool softener. Please take this regularly for the first week. Opening your bowels will tend to increase the discomfort level initially but will be helped by once again taking your painkillers regularly. There is a small sausage-roll type pack sitting within the anal canal following the surgery and this will be passed with the first bowel motion. There will be some dark coloured blood with it so don't be alarmed. Subsequent bowel motions for the first 48hrs will probably be small in amount.
Bleeding from the back passage, particularly with a bowel motion, is not at all unexpected. Occasionally you may get some bleeding that occurs between bowel motions. If you do see blood, do not be alarmed. You should where a pad if you think that possible leakage might be a problem. If you think that the bleeding is excessive then it is important to rest. If having done this the bleeding continues, particularly if you start to feel light-headed then contact Dr Renaut's rooms. If he is not immediately available then you should contact either your GP or the emergency department at your local hospital. I should stress that this scenario is most unusual.
The operation site is within an area that is relatively dirty. Having said that infection is unusual. To help combat this you will be given some antibiotics on the operating table and you will either be given some antibiotics to take home or a prescription which you should take to your local pharmacy. It is important to take these as instructed on the packet and to complete the course. Excessive pain beyond 5 days possibly suggests an infection that is not controlled by the antibiotics. Under these circumstances once again contact Dr Renaut's office. Certainly if you feel unwell, feverish or you start to vomit after the first few days of surgery please contact Dr Renaut as a matter of urgency.
Physical Activity (including sexual activity)
It is important to rest after your surgery - the more activity you do the greater the level of discomfort and the longer it will take to recover from your surgery. Nevertheless it is important to maintain some activity and certainly moving around the house and going for short walks is perfectly acceptable. How quickly you resume your normal day to day activities are very much based on common sense and should largely be guided by your level of discomfort. Activities such as house work, shopping and driving around should be left to somebody else for the first few days. Within a couple of weeks you should be able to resume your normal day to day activities. Activities such as going to the gym should be resumed on a gradual basis after a couple of weeks.
Please call immediately for advice if the following occurs:
- Excessive bleeding (initially apply firm pressure to the area for 15-20 minutes).
- Excessive swelling in the anal region.
- Increasing or excessive pain.
- Excessive discharge from the anal region.
- You feel you are becoming constipated.
Dr Renaut prefers to see his patients for a post-operative review at approximately eight weeks. If however you feel that this is not required then he would be happy for you to make a phone call to the office to this effect.