What is the fastest way to heal after fissure surgery?
It is important to note that complete healing with both medical and surgical treatments can take up to approximately 6-10 weeks. However, acute pain after surgery often disappears after a few days. Most people are able to return to work 1 to 2 weeks after surgery.
We recommend the following as the best way to recover from anal fissure surgery:
The most important thing you can do to facilitate your recovery is to keep your bowels soft and moving and avoid constipation at all costs. Most of the pain and discomfort that people have after this kind of surgery is related to bowel movements.
In the week prior to the surgery begin taking stool softeners such as Colace or Docusate and adding a fiber supplement to your daily routine such as Benefiber, Citrucel, Metamucil or a similar product. The goal is to have soft but formed stools.
Stay well hydrated and drink lots of fluids including juices and Gatorade. Your colon helps to maintain water balance in your body and if you get dehydrated this can cause constipation and hard stools.
You must continue to eat. Fasting to avoid having bowel movements does not work well as people find they end up feeling constipated after a few days and then strain to go to the bathroom, which is painful and can lead to fissures.
Eat a regular diet and avoid foods that are constipating; only you as an individual know what those foods are. Eat plenty of fresh fruits and vegetables. Avoid excessively hot and spicy foods that might burn on the way out.
As mentioned, most of the discomfort and pain that people experience is related to bowel movements and is directly due to spasm or cramping of the sphincter muscle, which is irritated because of the raw areas that were burned. The best way to get immediate pain relief is to soak in hot water immersing your pelvis as opposed to just taking a "sitz bath" while sitting on the toilet. We recommend that you soak 6 to 8 times per day. Immediately after a bowel movement, you should soak. Soaking helps people to heal better and more quickly, often provides immediate relief of anal pain even when pain medications aren't helping, improves the blood supply to the area, and keeps it clean.
Soak in hot water 6 to 8 times per day.
Pain control is very important. Be sure to discuss this with your health care provider and let them know what medications work best for you. If you can take medications like ibuprofen or Advil or naprosyn or Aleve, these can be very helpful in decreasing the pain and inflammation and you should take them around the clock when you are not taking your other pain medication. They are also not constipating.
Usually we prescribe extra strength Vicodin or hydrocodone, also known as Lortab, but some people require Percocet or oxycodone. It's important to realize that all of these pain medications contain acetaminophen or Tylenol and that patients should not take more than 4 grams per day, otherwise liver toxicity can occur. This translates to no more than eight (8) 500 mg tablets in a day. Patients with underlying liver disease such as chronic hepatitis should probably stay below this dose. Do not take extra Tylenol with these pain medications, but you can take Advil or Aleve.
All pain medications containing narcotics are constipating, so if you find that you are requiring a lot of pain pills, then you may need to take more fiber or stool softeners. Again, the goal is to avoid constipation at all costs. If you haven't had a bowel movement in 2 or 3 days, then consider taking a laxative such as milk of magnesia.
We also recommend that you apply topical numbing jelly to help ease the pain and decrease the need for narcotics, which can be done every 2 hours as needed. The most potent is called 5% anorectal lidocaine cream, or L.M.X.5, which can be purchased over the counter and does not require a prescription.
Unless patients have an allergy to sulfa drugs, they are sent home with a tube of Silvadene cream. This can be applied after bathing and is used to help decrease symptoms, because it is used for burn patients. If you find you would rather put the numbing jelly on and are not getting any relief from the Silvadene, then it's OK not to use it. Some people find as time passes after surgery that they begin to heal but still have external wounds that are slow to heal. In this case sometimes applying Desitin or zinc oxide ointment can be helpful.
It is normal to have bleeding and oozing after surgery and often it occurs with bowel movements. Do not be frightened about this and realize that just a few drops of blood will turn the toilet bowel red. If you are continuously passing blood clots or dripping large amounts of blood that doesn't stop with rest and simple pressure, call your physician. Rarely after surgery patients will have bleeding that is significant enough to require a trip back to the operating room on an emergency basis, but this is very uncommon.
If you had a lot of external disease treated, then you are more likely to have oozing and bleeding. Some people find that wearing feminine panty liners in their underwear can be helpful and cut down on the amount of laundry that needs to be done.
Infection is very uncommon, but if you develop a fever greater than 101.5 degrees Fahrenheit, then call your physician. Occasionally in people who are prone to herpes outbreaks and are not receiving suppressive medication such as acyclovir or Valtrex, a herpes outbreak can be precipitated by the surgery. If this happens, it often occurs 5 to 7 days following the surgery and is recognized by the fact that just when things started to feel better, they suddenly begin to feel worse.
Activity should be as tolerated, but we recommend that you take it easy for the first week or so depending on how you are feeling. You need time to allow your body to heal. You also need to be close to your bathtub to be able to soak. It's probably a good idea to avoid putting yourself in situations where you will have to stand or walk or sit for extended periods of time. As you begin to heal and the pain abates, you can begin to resume your normal activities. Heavy exercise in which you increase your intra-abdominal pressure such as heavy sit ups, squats and leg lifts should probably be avoided for several weeks because of the possibility of causing spontaneous bleeding by aggravating your hemorrhoids.
The good news is everyone gets better; it just takes time. Sometime between 7 and 14 days, things begin to turn around and improve. That's a good sign that you will continue to get better on a daily basis, but don't push it too hard or too fast. Some people do amazingly well and have almost no pain and discomfort. Some people take little to no pain medications. Recovery is a very individual experience and seems to be somewhat different for everyone.
We usually recommend that patients return to be examined 2 to 3 months following the surgery. This is ample time to allow healing and allow people to be examined without causing significant pain or discomfort. Continued follow-up is very important and you should continue to be monitored on a regular basis, because the HSIL can and frequently does recur. Frequent monitoring may catch it at a time when it can be treated in the office avoiding another operation.
Avoid anal intercourse for as long as directed by your healthcare provider. Anal intercourse may make it harder for your anal fissure to heal. It may also tear more tissue around your anus.
Use baby wipes or medicated pads, such as Tucks, instead of toilet paper after a bowel movement. These products do not irritate the anus.
Avoid using soaps with fragrance that can irritate the site.
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10 common questions about Precautions after fissure surgery
1How long is recovery after fissure surgery?
Most people can go back to work and their normal routine 1 to 2 weeks after surgery. It will probably take about 6 weeks for your anus to completely heal. Most people get better without any problems. But a small number of people have problems controlling stools when they pass gas.
2What should I do after fissure surgery?
Stool softener – For a few weeks after surgery, use stool softeners to aid the healing process. Change in diet – You can start eating normally from the same day post-surgery. You will be advised to adopt a fibre-rich vegetarian diet and increase fluid intakes to stop anal fissure from recurring.
3Can fissure come back after surgery?
It's important to understand that, even with surgery, an anal fissure must heal on its own. A sphincterotomy involves operating on the sphincter muscles, not closing the actual fissure. ... The results last longer, and fewer people have anal fissures come back after surgery than after treatment with medicine.
4How long after surgery will I poop?
After surgery, your caregivers will frequently ask whether you have passed gas. This is because passing gas is a sign that your bowels are returning to normal. You may not have a bowel movement for four to five days following surgery.
5Can I walk after fissure surgery?
Driving while taking them can impair your ability to drive safely. You should be able to return to work within 1-4 weeks after surgery, depending on what type of Anal Fissure surgery you had. The most important part of caring for your wounds after anal fissure surgery is keeping the area clean and dry
6How successful is fissure surgery?
Botox® injections are associated with healing of chronic anal fissures in 50% to 80% of patients. Sphincterotomy is successful in more than 90% of patients. Although uncommon, this procedure may affect the patient's ability to fully control gas or bowel movements
7Is walking good for fissures?
Regular exercise increases blood flow throughout your body, which may aid in healing the fissure. Exercise also promotes regular bowel movements. Finally, try not to strain when you have a bowel movement. ... A medicated cream such as lidocaine can help relieve discomfort as the fissure heals
8Can fissures cause cancer?
Anal Fissures and Colon Cancer
People with colon cancer may develop anal fissures, but anal fissures don't cause colon cancer or increase your risk of getting colon cancer. Even if your anal fissure heals completely, it can come back after you have a hard bowel movement
9Are fissures dangerous?
Too much pressure, tight anal sphincter muscles, and poor blood supply to your anus may lead to their development and poor healing. Anal fissures don't usually give way to more serious problems. They don't cause cancer. But they can be very uncomfortable
10Can fissure be cured permanently?
In the present study, 98% of patients presenting with a chronic anal fissure were successfully cured medically, avoiding the potential risk of permanent sphincter damage associated with surgery. In only 2 patients did a combination medical treatment fail to heal the fissure and they required sphincterotomy