Click on the procedure you have had performed for post-operative instructions:
- Rubber Band Ligation (RBL)
- Haemorrhoid Artery Ligation and Recto-Anal Repair (HAL-RAR)
- Haemorrhoidectomy
Rubber Band Ligation (RBL)
You have had a rubber band ligation procedure to treat your haemorrhoids.
Pain / Discomfort
After RBL, there is generally no pain. You may experience discomfort for 2-3 days, but more so the urge that you want to empty your bowels constantly. This is because of the location of the rubber bands close to the anal canal. Simple pain tablets such as Paracetamol or Nurofen should be sufficient. Strong pain killer tablets are generally not required however you will be given a small supply when you go home should you need.
Your Bowels
Your bowel habits may change temporarily after your operation. This is due to the rubber bands that have been placed inside the rectum and anus. Some urgency (needing to go quickly to the toilet) and frequency (having to go to the toilet more often than usual to open your bowels) is common initially after RBL. This will usually settle after 1-2 days, but can take up to 4 days. It is important not to become constipated or strain whilst having a bowel motion, so drink plenty of water and use a stool softener such as Movichol should you need.
You may experience bleeding from the bottom. A small amount of bleeding is not unusual in the first 1-2 days, and again after 5-7 days. Do not be concerned if you see the rubber bands fall off in the toilet bowl. This is normal and they can fall off anywhere between 2-7 days. If you develop heavy bleeding, or begin passing clots, contact Dr Jamnagerwalla’s rooms on (02) 8578 2805 or present to the Emergency Department at Sutherland Hospital immediately.
Work and Other Activities
You may resume work within 1-2 days. You should not lift anything heavy for one week if you can avoid to. All other day-to-day activities can be resumed the following day.
Driving
Legally, you are unable to drive within 24 hours after an anaesthetic. Therefore, you should not drive or operate any heavy machinery the day after your RBL procedure.
If you have any concerns or questions, you can phone Dr Jamnagerwalla’s rooms on (02) 8578 2805 or alternatively, speak to one of the nurses on the ward you were staying. Dr Jamnagerwalla will see you after 2-3 weeks. Please contact the rooms to make a follow-up appointment as advised.
Haemorrhoid Artery Ligation and Recto-Anal Repair (HAL-RAR)
The HALRAR procedure is generally less painful than a haemorrhoidecomy, especially if only a Haemorrhoid Artery Ligation (HAL) has been performed, without the Recto-Anal Repair (RAR).
Pain
You may experience discomfort for up to one week. Unlike a haemorrhoidecomy, there are no wounds around the bottom therefore pain is usually uncommon. Moreso, you may experience the feeling or urge of wanting to empty your bowels constantly. This is due to the RAR component of the procedure, in which the lining of the low rectum and the haemorroids are drawn up with stitches, giving the sensation of wanting to pass a bowel motion. This usually subsides within the first week. You may require simple pain tablets such as Paracetamol or Nurofen. Strong pain killer tablets are generally not required however you will be given a small supply when you go home should you need to take any.
Urinary Retention
The HALRAR procedure has a higher rate of urinary retention than other haemorrhoid operations. The cause of this is not clear. Should you feel that you are unable to pass urine adequately, or experience the urge of having a full bladder, contact the hospital or Dr Jamnagerwalla’s rooms immediately.
Your Bowels
Your bowel habits may change temporarily after your operation. This is due to the stitches that have been placed inside the rectum and anus. Some urgency (needing to go quickly to the toilet) and frequency (having to go to the toilet more often than usual to open your bowels) is common initially after surgery. This will usually settle within 1-2 weeks as the scarring process occurs. It is important not to become constipated or strain whilst having a bowel motion. You will be sent home on laxatives to help avoid this.
You may experience bleeding from the bottom. A small amount of bleeding is not unusual. It usually tapers off over the first few days. If you develop heavy bleeding, or begin passing clots, contact Dr Jamnagerwalla’s rooms or present to the Emergency Department at Sutherland Hospital immediately.
Work and Other Activities
It is advisable to have at least 1-2 weeks off work so that you are comfortable when you return. If you require a longer period off work, contact Dr Jamnagerwalla’s rooms or your GP for another work certificate.
You should not lift anything heavy for two weeks. All other activities such as swimming in the ocean, walking and spending time outdoors are allowed and encouraged.
Driving
Legally, you are unable to drive within 24 hours after an anaesthetic. After this time, you should not drive until you are confident that you can drive safely. You should not start to drive again until your strength and speed of movement are up to coping with an emergency stop. In general, you should refrain from driving for one week. You should also make sure that you are not drowsy from any painkillers and that your concentration is normal.
It might be sensible to check that you are insured to drive after surgery before you start driving again after your operation.
Remember…
After a HAL-RAR procedure, it takes up to 12 weeks for results to become evident, so be patient and don’t expect your haemorrhoids to go away quickly. It is a gradual process as the haemorrhoids shrink after their blood supply is reduced.
If you have any concerns or questions, you can phone Dr Jamnagerwalla’s rooms on (02) 8578 2805 or alternatively, speak to one of the nurses on the ward you were staying. Dr Jamnagerwalla will see you after 3 weeks. Please contact the rooms to make a follow-up appointment as advised.
Haemorrhoidectomy
You have had an operation to remove haemorrhoids. Your recovery from the operation will take 4-6 weeks. Here are a few points that will help after you have gone home.
Pain
Pain after haemorrhoid operations can last anywhere from 4-6 weeks. The first two weeks usually tend to be the most uncomfortable. This is because the skin on your bottom and the lining of the last portion of your bowel, the anal canal, has a very rich nerve supply. Haemorrhoid operations involve cutting the haemorrhoid away from the anal skin and inner lining of the anal canal, creating a raw wound, which heals slowly from inside to out. The aim is to make things as comfortable as possible for you during your recovery. You will be sent home on a combination of strong and simple painkiller tablets. For the first 1-2 weeks, use these as directed however aim to taper the strong pain killers as quickly as possible and use simple ones such as paracetamol and/or Nurofen more regularly. You will also be sent home on an antibiotic named Metronidazole. Even though this is an antibiotic, it is used to reduce pain after haemorrhoid operations. You should continue this for 3 days.
Salt Baths
Salt baths are an excellent way to relieve the pain and discomfort after your anal surgery, and to help the wounds stay clean and heal. Purchase Epsom salts from the chemist and sprinkle a handful into a luke-warm water bath and bathe yourself for 20 minutes 1-3 times/day. The more times, the better. Most people feel the difference after a nice salt bath to help with their recovery. Continue this for as long as you can.
Your Bottom and Bowels
The areas where the haemorrhoids have been removed from your bottom are like a very shallow open wound, or a graze. This can take between 6-8 weeks to heal. As the wound heals, it will weep, therefore have a dry absorbent pad on the inside of your underwear to prevent your clothes from staining. The discharge is usually a clear liquid, but it can contain a thick jelly-like substance (mucous) or blood. These are all normal. Bleeding is not unusual as wounds are healing. It usually tapers off over the first two weeks. If you develop heavy bleeding, or begin passing clots, contact Dr Jamnagerwalla’s rooms on (02) 8578 2805 or present to the Emergency Department at Sutherland Hospital immediately.
You will be sent home on laxatives to help keep your bowels soft. You must avoid becoming constipated or “holding off” on going to the toilet for fear of pain. This will make things worse therefore take the laxatives daily to achieve a soft, smooth bowel motion every day. Some urgency (needing to go quickly to the toilet) and frequency (having to go to the toilet more often than usual to open your bowels) is common initially after surgery. This will usually settle within a few weeks as the wounds and scar go through the healing process.
Work
Generally, it is advisable to have at least two weeks off work as you may be uncomfortable sitting for prolonged periods of time. If you require a longer period off work, contact Dr Jamnagerwalla’s rooms or your GP for another work certificate.
Driving
Legally, you are unable to drive within 24 hours after an anaesthetic. After this time, you should not drive until you are confident that you can drive safely. You should not start to drive again until your strength and speed of movement are up to coping with an emergency stop. In general, you should refrain from driving for one week. You should also make sure that you are not drowsy from any painkillers and that your concentration is normal.
It might be sensible to check that you are insured to drive after surgery before you start driving again after your operation.
Remember…
Haemorrhoid surgery is uncomfortable. You should begin feeling more comfortable after the first two weeks. Use the medications given to you for pain and ensure you do not get constipated. Have salt baths regularly. Use simple absorbent pads inside your underwear whilst the wound is healing as it will weep until it is fully healed, usually 6-8 weeks.
If you have any concerns or questions, you can phone Dr Jamnagerwalla’s rooms on (02) 8578 2805 or alternatively, speak to one of the nurses on the ward you were staying. Dr Jamnagerwalla will see you after 4-5 weeks. Please contact the rooms to make a follow-up appointment as advised.
