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Dr. Baker HensonDO, FACS · Hickory, NC Book Appointment

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Anorectal Problems & Procedures
Postoperative Instructions

Postoperative instructions and recovery guidelines for anorectal procedures.

Preventing Constipation & Stool Softeners

The key to a smooth recovery is keeping your bowel movements soft and regular. This allows stool to pass easily, minimizing strain and protecting the healing tissue. Your goal is to have soft, formed, and bulky bowel movements. Both hard stools (constipation) and diarrhea can cause irritation and should be avoided.

To keep your digestive system moving gently, please follow these steps daily:
  1. Hydrate: Drink at least 8 glasses of water every day.
  2. Fiber: Take 2 tablespoons of Metamucil (or an equivalent fiber supplement) mixed with a liquid of your choice.
  3. Colace (Over-the-counter): Take one 100 mg tablet up to 3 times per day as needed.
  4. Senokot (Over-the-counter): Take 1 to 2 tablets up to 3 times per day as needed.

Note: Please avoid harsh, strong laxatives (like Miralax or GoLytely) unless the gentle measures above are not working. Additionally, do not use suppositories or enemas, as they can cause trauma to the healing anal tissue.

Pain Management & Sitz Baths

You may be prescribed a narcotic pain medication for the first few days of your recovery. Please take this only as needed for immediate relief of severe pain. Unless we have instructed you otherwise, you should also utilize over-the-counter pain relievers like Tylenol or Ibuprofen (Motrin).

Important: Because narcotic pain medications are highly constipating, it is absolutely crucial that you actively use the over-the-counter stool softeners mentioned above while taking them.

The Power of Sitz Baths: We highly recommend taking "Sitz baths" to reduce pain, swelling, and muscle spasms. Simply sit and soak in a few inches of plain, warm water in your bathtub for 15 minutes. This is incredibly soothing and is the best way to keep the surgical area clean, especially right after a bowel movement. You can do this as often as you find helpful.

Prescription Ointments (If Applicable)

If you are being treated for an anal fissure or a sphincter muscle condition, you may be prescribed a specially compounded Nitroglycerin ointment. Applying this to the skin directly around the anal opening 3 to 4 times a day helps the medication absorb into and relax the sphincter muscles, allowing tears to heal naturally. While you may notice symptom relief in 1 to 2 weeks, complete healing can take several months. Note: A known, temporary side effect of this ointment is a mild headache.

Activity & Returning to Work

We encourage you to stay active! Walking, light jogging, driving, and climbing stairs are completely fine as long as they don't cause you significant discomfort. Routine movement will not harm the healing tissue. If your job or daily routine requires prolonged sitting, using a pillow or a "donut" cushion can help relieve direct pressure from your bottom.

You are cleared to return to work as soon as you feel comfortable performing your normal duties. You do not need to wait for your follow-up appointment. If you need a formal return-to-work note, please call our office and we will happily fax it to you or your employer.

When to Contact Us

It is completely normal to experience some minor issues during recovery, such as a low-grade fever (under 100°F), mild itching, or a small amount of bright red blood on your toilet paper after a bowel movement. As long as you are seeing gradual improvement day by day, you are on the right track.

Please call our office immediately (before your next scheduled visit) if you experience any of the following:
  • High, repeated fevers over 101.5°F, chills, or severe night sweats.
  • Dizziness, severe fatigue, a racing pulse (over 120 bpm), or low blood pressure.
  • New or worsening chest pain or shortness of breath.
  • Nausea or vomiting that prevents you from keeping liquids down for more than a day.
  • Severe abdominal bloating, pain, or vomiting due to persistent constipation.
  • Pain that is actively worsening over several days rather than improving.
  • Inability to urinate, or persistent burning and bleeding during urination.
  • Increasing redness, warmth, swelling, or thick, cloudy drainage from the surgical site.
  • Heavy, continuous bleeding from your bottom, or passing large maroon or black blood clots.