PATIENT INFORMATION SHEET FOR HAEMORRHOIDECTOMY
You have been scheduled for a haemorrhoidectomy, an operation to remove haemorrhoids
(piles). This is performed under general anaesthetic (fully asleep). Any stitches used are
dissolvable. At the end of your surgery you may have had some packing inserted into your anus –
if so this will dissolve and you may notice it in your first bowel movement. No packing needs to be
removed.
PREPARING FOR ADMISSION TO HOSPITAL
Please fill out and send all forms given to you to the hospital as soon as possible. This will
help facilitate your admission process at the hospital. Read the hospital information given to
you as this will answer any hospital specific questions you may have. If necessary ring the
hospital to discuss any queries (e.g. accommodation choice).
Should you have any questions regarding your private health cover direct these to your
insurer i.e. hospital excess.
If you have any queries regarding your anaesthetic or out of pocket expenses i.e. any gap
which may be payable to the anaesthetist, please contact the anaesthetist directly. You will
be given their name and contact number at the time your surgery is scheduled.
Prior to your admission arrange your transport home at discharge. Anticipate what you may
need at home for the days after discharge, for example food supplies, to make coming home
a little easier. Do you need to make any physical changes at home i.e. is the telephone in the
best place. Be ready to come home!!!
Use the time you have from scheduling your surgery to your admission to optimize your
health status – keep active, if you smoke use this time to stop or at least reduce the number
you smoke per day, eat a healthy well balanced diet. You may benefit from dietary
supplements e.g. multivitamins or protein drinks such as Ensure. These measures will
contribute to your recovery.
Arrange “time off” from your work place if required. Your doctor will have given you an idea of
your recovery time when scheduling your surgery. An appropriate sick certificate will be
provided if necessary but please note this can not be written prior to your operation.
You will be admitted to hospital the day of operation. Your doctor will instruct you regarding
medications that need to be held prior to surgery. Chronic condition management will be
reviewed as indicated and any changes implemented as required. Specific preparation i.e.
bowel preparation, fasting and admission time will be given to you when surgery is arranged.
Please ensure that you take all current medications into hospital with you in their original and
labeled packaging.
DAY OF ADMISSION
Having followed the specific instructions preparing you for surgery, shower, wash your hair
and clean your teeth in a timely manner before leaving for hospital.
Your arrival time, allows for your admission process. You will be seen by the anaesthetist and
any other orders from the doctor will be carried out.
If your doctor has indicated that your next of kin will be contacted following surgery we advise
that the person to be contacted not wait at the hospital. Your doctor will contact them by
telephone at the earliest convenience.
RECOVERY
Please remember each person’s recovery following surgery is individual, the following information
is designed as a guide to assist you during this time.
Your hospital stay
While in hospital you will be encouraged to actively participate in your care to optimize your
recovery. We advocate for example regular deep breathing, coughing and leg exercises and
encourage sitting out of bed and ambulating a soon as possible after surgery.
Discussing your individual needs with the nursing staff looking after you is essential to
facilitate your care.
This particularly relates to pain management.
Surgery causes some degree of pain or discomfort and everyone has their own pain
threshold.
Effective pain control is essential for your recovery. There will be different forms of pain
relief available depending on your level of pain or discomfort.
Poorly controlled pain can negatively impact your recovery.
Pain will impede your ability to move effectively or do regular exercises.
This can potentially lead to problems such as the formation of clots in your legs or lungs
and chest infection.
As a result of such complications your health and recovery are compromised and your
hospital stay may be lengthened.
If your pain relief is ineffective please discuss this with the nursing staff.
After discharge from hospital
If you are discharged the day of or the day after surgery it may take 24 hours or more to recover
from the anaesthetic. During this time you should not drive a vehicle, operate machinery or power
tools, consume alcohol or make any major decisions. A responsible person should remain with
you.
PAIN
You may experience a moderate amount of pain or discomfort in your anal/rectal area during the
first 3 – 5 days after surgery. You should be relatively comfortable about a week to ten days after
the operation. Mild discomfort with bowel actions may continue for a few weeks. The pain tablets
prescribed for you at discharge should be used as directed – if you can, take these 15 – 20
minutes before opening your bowels. The pain/discomfort associated with having a bowel action
will progressively lessen. You may feel as if there is some local swelling around your anal region
and may even give you the urge to use your bowels – this will subside with time.
BLEEDING
It is expected that you will have some bleeding, particularly with bowel movements and this may
continue for up to a month after surgery. There may also be some mucus discharge for a few
weeks while the area is healing, this is normal. You may find it helpful to wear a sanitary pad in
your underwear.
DIFFICULTY PASSING WATER
(This may sometimes be a problem for men.) If you experience difficulty in passing water, ensure
that you take your pain medication as ordered, sit in a warm bath, or have a shower and attempt
to pass urine while relaxed. This may be all that is required. If this does not help and you are in
discomfort ring your doctor or go to your nearest hospital with an emergency department.
AVOID CONSTIPATION
You need to continue taking the laxative your surgeon ordered until you are having regular, soft,
formed bowel movements. It is also very important that you eat a well balanced, high fibre diet eg
fruit, vegetables, wholegrain breads, bran based cereals and drink at least 6 – 8 glasses of water
a day (more in hot weather). Please be aware that pain medications can be constipating and
therefore the combined effects of diet and laxative use are very important.
Increase your daily activity once you are comfortable - to also assist in reestablishing a good
bowel habit. If you are experiencing loose, frequent bowel actions stop the laxative.
Medications
Pain relief medication will be arranged at discharge. Take as directed and heed any warnings
on the packaging.
You may only need this stronger pain relief for the first few days after your operation then a
simple medication such as paracetamol (taken as per packaging) may be all that is
necessary.
Please be aware that some pain relief medications can be constipating – pay attention to
your diet and fluid intake. A mild laxative may be necessary to ensure you are having regular,
soft formed bowel actions.
If you have been prescribed antibiotics please ensure that you complete the course of tablets
prescribed.
You can resume your normal medications; however your doctor will advise you when you can
resume i.e. Aspirin or other blood thinning medications.
Activity
There are no restrictions on your normal daily activities; you can do what ever causes you no
discomfort. Avoid being sedentary, walking is good for your post operative recovery.
However do not do any heavy lifting or strenuous activity for 7 – 10 days (to help reduce the
chance of bleeding and facilitate healing).
Continue with deep breathing, coughing and leg exercises as instructed in hospital and wear
the anti-thrombosis stockings (if you were fitted) until you have returned to your normal level
of activity.
You may find that you tire easily initially and that an afternoon rest is required. Be sensible,
listen to your body.
You may drive when you feel comfortable and in no way feel limited in your driving ability
because of surgery.
Activities such as sex and working behind a desk can resume as soon as you are
comfortable. Return to strenuous physical work or sport will depend on the surgery you have
had and may be up to four to six weeks after surgery or advised by your doctor.
Anal care
Keep the anal area clean and dry, wear a soft absorbent sanitary pad in your underwear –
change this several times a day
Take warm baths 3 – 4 times a day, especially after bowel movements, no additives are
necessary. The water temperature should be as warm as you can tolerate – but check the
water temperature with your elbow to make sure that it is not too hot. The baths are cleansing
while both soothing and relaxing. A plastic basin that fits in the toilet is also an alternative as
is using a hand held shower hose to gently irrigate the area.
You may find using a pre dampened toilet tissue or alcohol free wet wipes more comfortable
than dry paper for gently cleaning yourself.
Bowel movements
Do not strain during a bowel movement, it is best to wait for the urge.
Try not to sit for prolonged periods on the toilet.
Continue with good bowel habits i.e. high fibre diet (include a fibre supplement such as
Metamucil if necessary), drink 6 – 8 glasses of water per day and maintain an active lifestyle.
Diet
There is no restriction to your diet – a well balanced, high fibre diet and adequate fluid intake
(i.e. 6 – 8 glasses of water a day) is very important.
You may find that you can return to this diet very quickly, or you may feel like smaller, lighter
meals initially. Be sensible and be guided by how you feel and your appetite.
Follow up
Please make sure you have an appointment with your doctor 4 – 6 weeks after your
operation, or as directed.
PLEASE CONTACT YOUR DOCTOR OR GENERAL PRACTITIONER (GP) IF YOU
EXPERIENCE ANY OF THE FOLLOWING AFTER DISCHARGE FROM HOSPITAL
.
YOU EXPERIENCE PROLONGED OR PROFUSE BLEEDING WITH PASSAGE OF
CLOTS, please go direct to a hospital facility with an emergency department. Try
and apply firm pressure to the area.
Inability to pass urine within 12 hours if you went home on the same day as your
operation. If unable to contact your doctor please go to your nearest hospital with an
emergency department
You experience nausea and vomiting which does not settle.
You experience fever or chills and sweating
You have a temperature above 38° C.
Anal / rectal pain is not relieved by the pain relief medication you have been prescribed or
is getting more severe in nature.
Anal discharge is increasing, purulent and offensive.
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