Surgery

• The patient will be given a regional (local) anesthetic to temporarily numb the body from the waist down or general anesthesia that puts you to sleep to prevent you from feeling pain. An anoscope (an instrument to view the anal canal) will be inserted. The surgeon then can remove the swollen veins.
  
  

Post-Operative Instructions

• After the surgery, the nursing staff monitors the patient until the anesthesia is worn off and the patient is stable. Sometimes general anesthesia causes nausea and vomiting, so fluids are administered through an IV until clear liquids are tolerated. The spinal anesthesia wears off in a few hours; however, patients need to lie flat on their backs to avoid the risk of anesthesia-induced headaches. A patient is released from the hospital when all vitals are normal.
  
  A patient may experience discomfort after the anesthesia wears off, so pain medications are usually prescribed. Such medications as acetaminophen (Tylenol) and ibuprofen (Motrin/Advil) can be used throughout the day. Some doctors frown upon using narcotic pain medicines, as they cause constipation, and hard stools can cause tearing in the anus after the surgery. A stool softener also may be prescribed to prevent hard stools. Ice packs may help reduce the swelling, and stiz baths (soaking in a tub of water) several times a day helps ease the discomfort while promoting healing.
  
  There may be some bloody discharge during the first few weeks when passing a stool. Gauze or feminine napkins can be used to soak up any leakage. There may be stitches on the external anal area that will dissolve. Infection is not a major issue, although some doctors prescribe an antibiotic ointment to be place on the wound. Later, patients may prefer to use a soothing cream like Preparation H or Anusol.
  
  Straining during a bowel movement must be avoided. Make sure to drink six to eight glasses of water daily along with a fiber supplement like Metamucil or Citrucel every day. The bathroom is not intended for reading; so do not sit for long periods of time.
  
  There is a special donut-shaped pillow available for purchase at pharmacies and medical supply stores to help make sitting more comfortable during your recovery period. Another important issue is not to lift anything heavy for at least two to three weeks. Return to your surgeon for a post-operative appointment to discuss when you can return to work and what activities you can resume.
  
  Call the doctor immediately if you have excess bleeding, cannot urinate or pass bowel movements or run a fever.