AFTER CARE INSTRUCTIONS ANORECTAL SURGERY PAIN Bowel movements after anorectal surgery are usually painful. Although this will diminish as the healing progresses, the pain will usually require use of narcotic pain medication initially and close attention to appropriate aftercare. You will be given a prescription for a pain medication. The narcotic (usually Darvocet N-100) can be taken every four hours as needed. Your pain will be most severe the first three to five days following surgery, and then it should gradually subside. You may also be given an anesthetic ointment after surgery, which may be applied after each Sitz bath. INCISION You may remove the dressing applied before your first Sitz bath or bowel movement. You should begin warm Sitz baths on the evening of surgery, and continue three times a day for 10-15 minutes, especially after bowel movements. Some bloody discharge, especially after bowel movements, can be expected. If there is prolonged or profuse bleeding, however, you should call our office. You should avoid using dry toilet tissue after bowel movements. The best course of action is to gently wipe yourself with a wet cotton ball, then take a shower or Sitz bath, then dry the area with a hairdryer. If you cannot shower or bathe, then use Balneol lotion on cotton balls or baby wipes. ACTIVITIES No strenuous exercise or heavy lifting should be attempted until healing is well under way. Climbing stairs, walking and car riding may be done in moderation as tolerated. DIET No restrictions, but you should include plenty of fiber and water. You may take a tablespoon of Metamucil a day with a full glass of water as your fiber source. You will be given a prescription for a stool softener, which you should take twice a day as instructed. If you do not have a bowel movement in 48 hours after surgery, you should take one ounce of milk of magnesia, and repeat it in six hours if no results are obtained. FOLLOW UP You should call the office for a follow-up visit in two weeks.