After hemorrhoid and anal fistula surgery, patients may still feel pain at the wound site on the first night, but it can be relieved with painkillers, and the symptoms usually improve significantly the next day. Some patients may be more concerned about anal fistula surgery than hemorrhoids because it is a less familiar condition with a strange name. However, in reality, anal fistula wounds usually hurt less and can be easily cared for properly as follows..
Wound Care After Hemorrhoid and Anal Fistula Surgery
Dr. Theerasanti Tantitemit, a colorectal and anal specialist surgeon at Phyathai 2 Hospital has recommended the following guidelines for wound care after hemorrhoid and anal fistula surgery:
- The wound can be cleaned with clean water. Tap water can be used to wash the wound as usual; saline is not necessary.
- A clean showerhead or bidet spray can be used to rinse the wound and anus area.
- Use mild soap to clean the wound in the morning, noon, evening, before bedtime, and at least after bowel movements.
- Wash the wound if you feel pain, burning, itching, or wetness around the anus or anus area. You can wash as often as needed; it is not necessary to wash only after defecation.
- Gently pat the wound dry after cleaning using a clean cloth or soft tissue paper. Do not rub hard as it may cause inflammation or bleeding.
- The appropriate positions for recovery after surgery are lying on the back, side, or stomach.
- You can eat normally, including regular cooked rice; there is no need to eat only soft foods.
What to Know and Precautions After Hemorrhoid or Anal Fistula Surgery
- Do not soak the anus in warm water or potassium permanganate solution unless necessary.
- Rest from work, avoid excessive walking or prolonged sitting.
- Avoid alcoholic beverages.
- The first bowel movement the next day will be painful but not as much as expected.
- Do not strain if you do not feel the urge to defecate.
- Avoid strong straining; you should strain about half as much as usual.
- There may be slight bleeding in drops during bowel movements that stops afterward. If bleeding is more than that, consult a doctor.
- There should be no blood clots coming out.
- After surgery, the wound may be swollen around the suture knots and anus, which can be felt according to the number of hemorrhoid heads removed. The wound will shrink as the sutures dissolve, usually about 3 weeks after surgery.
- After anal fistula surgery, some patients may have a lot of pus and lymph discharge initially. Pain and lymph discharge will decrease after the first week.
- About 1 week after anal fistula surgery, patients can resume daily activities and exercise normally.
- For hemorrhoid surgery, exercise should be resumed after about 2 weeks because bleeding may occur.
- Hemorrhoid surgery wounds will heal normally within about 1-2 months, but anal fistula wounds may take up to 3 months.
Observations Regarding Bowel Movements After Hemorrhoid and Anal Fistula Surgery
Constipation or No Bowel Movement
- If you cannot have a bowel movement for more than 2 days, you should use laxatives such as MOM (Milk of Magnesia) 30 cc, or you may use rectal enemas such as Unison, Fleet, Enema, or Glycerine. If these do not work, consult a doctor.
Frequent Bowel Movements
- After surgery, you may feel the urge to defecate faster than usual, causing frequent bowel movements. However, too frequent bowel movements are not good for the surgical wound and you should consult a doctor promptly.
After Hemorrhoid or Anal Fistula Surgery, If You Have the Following Symptoms, You Must See a Doctor Immediately
- Passing large blood clots with little stool.
- Severe wound pain, fever, constant pain, large amounts of pus or lymph discharge.
- High fever of unknown cause and decreased consciousness.
