Patient education: Hemorrhoid removal – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is hemorrhoid removal? — This is a procedure to treat hemorrhoids. Hemorrhoids are swollen veins in the rectum.

Hemorrhoids can be:

●Internal – You cannot see the hemorrhoid because it is hidden inside the rectum.

●External – You can see or feel the hemorrhoid around the outside of the rectum (figure 1).

Some procedures can be used for internal or external hemorrhoids. Others can only be used for internal hemorrhoids. Surgery to remove hemorrhoids is called "hemorrhoidectomy."

How long it takes for you to recover, and what you need to do, depends on which type of procedure you had. If your hemorrhoids were treated in the office, you might have less pain and can return to your normal activities sooner. With surgery, it usually takes longer to recover.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

You should also:

●Take all of your medicines as instructed. Make sure that you know when to start taking any medicines you had stopped before the procedure.

•Use the creams or ointments your doctor prescribed. Wash your hands before and after applying them.

•Use a stool softener to help prevent constipation.

•Take non-prescription medicines to relieve pain, such as acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand name: Aleve). These can be used instead of opioids, which can cause constipation.

●Soak your buttocks in 2 or 3 inches of warm water – You can do this up to 2 to 3 times a day for 10 to 15 minutes. Do not add soap, bubble bath, or anything to the water.

●It might be more comfortable to use a moistened wipe to clean the area. Gently pat to dry it instead of wiping.

●Try to prevent constipation and keep your bowel movements soft. You should have a bowel movement at least a few times a week. Here are some steps that you can take:

•Eat lots of fruits, vegetables, and other foods with fiber (figure 2). Fiber helps to increase bowel movements.

You need 20 to 35 grams of fiber a day to keep your bowel movements regular (table 1). If you do not get enough fiber from your diet, you can take fiber supplements. These come in the form of powders, wafers, or pills. They include psyllium seed (sample brand names: Metamucil, Konsyl), methylcellulose (sample brand name: Citrucel), polycarbophil (sample brand name: FiberCon), and wheat dextrin (sample brand name: Benefiber). If you take a fiber supplement, read the label so you know how much to take. If you're not sure, ask your doctor or nurse.

•Drink plenty of water and other fluids. This is especially important if you take a fiber supplement.

•Limit fatty foods and alcohol. These can make constipation worse.

•Take medicines called "stool softeners" such as docusate sodium (sample brand names: Colace, Dulcolax). These medicines increase the number of bowel movements you have. They are safe to take and can prevent problems later.

●Do not put anything in your rectum, unless your doctor told you to. This includes suppositories or enemas.

●Avoid heavy lifting, sports, and swimming for at least a week or 2. (Your doctor or nurse will tell you exactly how long to avoid these or other activities.)

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

When should I call the doctor? — Call for advice if:

●You have new or increased bleeding from your rectum. It is common to see blood for a few days up to a week after hemorrhoid removal. Mucus discharge might last a bit longer.

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You cannot pass bowel movements because of pain.

More on this topic

Patient education: Hemorrhoid removal (The Basics)
Patient education: Hemorrhoids (The Basics)
Patient education: How to take a sitz bath (The Basics)
Patient education: High-fiber diet (The Basics)

Patient education: Hemorrhoids (Beyond the Basics)
Patient education: High-fiber diet (Beyond the Basics)