I wanted to create this thread because I recently had a traditional hemorrhoidectomy combined with a sphincterectomy and wanted to share my experience with those who will be going through this procedure and encourage them to share their experience here as well. Before going through the surgery I read the posts on this site and benefited greatly from other people's experience and recommendations. So, I decided that I will give back to this community by sharing my experience with people, who like me, need to know what they should expect after their surgical procedure. The information I read made my recovery a lot less anxious and painful than it would have been had I been satisfied with the little information provided to me by my surgeon's office. I'm a doctor myself, but there's no experience like first hand experience. Knowledge is power!
So, I'm a 40 year old guy and had a traditional hemorrhoidectomy and a sphincerectomy at the same time. Actually, I was in to only do the sphincterectomy to address a non-healing fissure following a bout of severe gastroenteritis following a viral (Norwalk virus) infection several months earlier, but in the middle of the operation, the surgeon spoke to my wife in the waiting room, and they collectively decided to do the hemorrhoidectomy as well. Otherwise, I didn't have significant symptoms from the hemorrhoids (although I was a grade 3).. just the fissure.. well, let me tell you this, if I had known exactly what's involved afterwards I would have not let him do the hemorrhoidecomy! It's not a procedure you do just because you're in the area! But in retrospect, if all heals well I'm still glad that I did it since the traditional hemorrhoidectomy has the highest success rate of addressing the hemorrhoids definitively and with only a 5% chance of failure.
I don't want to exaggerate the post op but you should basically write off two weeks of your life... The first week was still like a distant memory to me as I was on pain meds 24/7 and was just trying to pass time in bed. I was prepared since I had read all these posts here and knew it was not going to be a hay ride! So, I took it with the understanding of what to expect ...and that helped a lot... but I tell you, just like others in this forum, I too have developed a healthy dose of empathy for people in pain and for humanity as a whole!... I actually specialize in treating people with pain in my practice ... I would say this was a transformative experience for me. I'm a better person for it and a better doctor for sure as I see my patience and understanding has grown exponentially for my patients. In this case, the suffering is considerable but you know there's light at the end of the tunnel and that really makes a difference because you know you'll eventually get better (unlike a cancer patient or someone who's terminally ill and in pain). That makes it more bearable since like child birth, you know it will be over and things will be back to normal at some point. Here, of course, you're dealing with a 10 day long labor!
The constant dull pain in your ass is something you wouldn't wish on your worse enemy! The other thing is that we as humans have an exceptional ability to forget! Maybe that's why we have multiple kids and that's why my unbearable pain two weeks ago is already like a distant dream (or nightmare!!) I guess that's good news for any one doing this procedure... it's very hard but it gets better. Today, I had a BM and didn't have much discomfort. That's great! The healing is progressing and a good month is needed for being in good shape. Most surgeries heal within 3 weeks in the human body as this is the time period for the cells to get in there, close the gaps, and revascularize and repair.
Much like most people here the surgeon really didn't prepare me for what was in store for me. I assume no one would do the procedure if they knew ahead of time; but it's also true that most people are happy a few months after it's done! It's like getting over a mountain to reach an oasis on the other side. You don't want to do it and it's hard; but the other side, well, it's worth it! Just plan and be prepared. You shouldn't plan anything for two weeks other than bed rest and some walking after the first week. For some, it may take longer and for others it may be less... but I doubt it anyone is ready to walk about sooner than a week if they've had the same procedure I had (Traditional Hemorrhoidectomy).
For the first week, I was in bed the whole time.. only walked back and forth to the bathroom... That was the extent of my exercise. The first time I came out of the door of my home was a good 7 days after surgery. Some people apparently have a different experience but my surgeon told me immediately post op that my fissure was on the posterior wall of the anus and that's where he found clusters of hemorrhoids... he added this area is rich in nerves and then gave me an empathetic look! I was like sh*t, I'm going to leave my butt here if you don't mind and will pick up in a month! Anyway... I went home same day, Surgery at 8:30AM and in the car heading home at 1PM. I had the procedure done under LMA (not full intubation anesthesia and very comfortable, safe, and no side effects). I did not get a spinal. I returned to work 10 days after the surgery but I was in pain for the first few days at work! I would seriously recommend taking 3 weeks off for this procedure (If not a whole month!) But 10 days post op I was taking the occasional Tylenol and Advil. The pain in later stages is just a constant dull ache often triggered after BM and lasting several hours thereafter.. it's not like it will kill you but it's distracting as it's relentless. But no lifting or heavy exercise for a while. I'm still not back to the gym. I plan to do so at about 3 weeks post op.
Anyway.. this is my pain control recommendations for those going through this procedure. For the first few days, I did not take any Percocets at all! I just took a combination of Ibuprofen and Tylenol. Specifically, I took 400mg of Ibuprofen, then two hours later, I took 500mg of Tylenol, then two hours later I took 400mg of Ibuprofen, then two hours later 500mg of Tylenol and 5mg of Flexoril (a muscle relaxant). This was my own recipe as I explained I'm a doctor who specializes in patients with acute pain.... I didn't want to take narcotic as it would cause constipation and more difficult Bowl Movements. I worked out the plan ahead of time and the dosage is not toxic for an average weight individual (I'm 180 lbs and in excellent shape). Your max daily dose of each Ibuprofen and Tylenol is 4g (or 4000mg) for an adult. So, you can take 4g of Tylenol per day and 4g of Ibuprofen. The two drugs don't interact with each other and piggy back off of each other. Most recent studies have clearly shown that the combo of these two over the counter meds are as effective - if not more effective - than narcotics (but without the side effects!) So, it's safe to take them concurrently. The pain was very bearable with this formula. The 5mg of Flexoril every 6 hours was especially very helpful for the first 4 days as it helped me sleep around the clock for the during that time and relaxed the muscles down there. I definitely recommend it as the one prescription you should take. My iPhone's timer was set up to wake me up every 2 hours, where I would take my pills according to schedule with plenty of water and go back to sleep (no matter what, even if I didn't have any pain!) It's important to combat pain before it arrives (that's true about any procedure.) Taking analgesics after you have pain is very ineffective as pain itself brings about more pain through involuntary muscle contraction and release of pro-inflammatory neuropeptides. So, you must go on this regimen before the local anesthesia (Marcaine) from the surgery wears off in the rectal region and have to be on it for about 4 days straight without missing a beat (you should consult your physician if you have a history of liver disease or bleeding tendencies/bad stomach!) It's tough but it really makes the whole experience less painful. I only had some discomfort after the BMs in the early phase. After 3 days or so I would take a Percocet once in a while after a BM to see it it helps more, which it didn't for me.
My diet consisted of vegetable soups and lots of fruits/water (I was also drinking plenty every two hours with my pills.) I had the surgery on Thrusday morning and I had a first BM Friday night. I think that's because of not taking narcotics and taking a healthy dose of fruits and vegetables. I did not take any laxatives at all. Completely natural (except for the Tylenol, Ibuprofen, and Flexoril!) Well, as you've heard here everywhere the Bowel Movements are the single most unpleasant experience of one's life during the recovery phase. Since I wasn't on narcotics and taking a lot of fiber via vegetables, I was having three fairly large BMs around the clock since that Friday night!! Well, very quickly I realized I don't need to be fibered up that much! It's not worth the pain after a BM and I'm not trying to break a record over here with my intestinal motility! I regulated my fiber intake so I would have one BM per day thereafter, which was my routine from before surgery.
Here's what I would do for the BM every morning, when I usually go (my routine): Wake up and immediately apply a little topical anesthetic to the anus area. Then turn the hot water in the bath tub and start filling the bath (hot water!) Meanwhile, have some high fiber cereal. Then get a Sitz Bath going on the toilet (the water in the Sitz bath as warm as I could tolerate without burning my ass!) As soon as I would sit on the Sitz bath this would trigger the relaxation of the sphincter muscle and initiate the bowel movement. I know it sounds gross but the best way to make your BMs painless is to just go in the Sitz Bath! Hey, it's your own sh*t and if you're eating lots of fiber it's really not a big deal! I would have 3, sometimes 4 passings of stool during each bathroom session. So, after each passing I would empty the Sitz Bath bowel and its content into the toilet, flush, rinse and refill the bath with hot/warm water. This process would take a couple of minutes, so buy the time I would sit back down into the newly filled fresh hot water of the next Sitz Bath it would immediately trigger the next BM. So, this would repeat 3-4 times and then I would finally sit down in a fresh water Sitz Bath with just lukewarm water and activate the water bag that would work like a bide and clean up the area. Didn't require wiping as a result.
This way, the actually passing of stool was not as painful as the pain after the passing when the sphincter would go into contraction again. Believe me, I'm the biggest neat freak, but necessity is the mother of invention and if I could do it so can you. So, once I felt the area is clean I would move to the bath tub which was hot and full at this point. In the bathtub I would watch a couple of episodes of Family Guy on my iPad and just relax with the goal of relaxing my sphincter (oh what lofty goals!) Yes, you have to distract yourself 24/7.. if you think about the whole experience then it becomes overwhelming... but if you just think of it mechanically and understand your goal is to pass time and let your body do what it needs to do... then it's a lot easier. My recommendation is get NetFlix and watch a thousand old shows on their instant streaming! You can't really get comfortable sitting in the early phase of healing (or at least I couldn't!) So, I was always lying on the side in bed... and watching these shows on my computer or tablet was all I could do to distract myself, or sleep.
Anyway... it gradually got better over time and while it still hurts it's much much better (Thank God, or whoever or whatever is in charge of and overseas my butt!)... actually, today, I didn't take any pain killers at all. I haven' done so in a couple of days and seem to be healing well. I'm still having my BMs in the Sitz Bath though! Yes, gross... and I tell you, the thought of it before this surgery would have caused nausea for me but it's amazing how we are as human beings and how WE CAN deal with adversity! The Sitz Bath BM, in my opinion, is a key, key factor! Get over it! The hot water relaxes your sphincter and allows for a much easier passage... Almost immediately after you sit in the hot water you'll have your BM! Just make sure it's hot enough.. obviously you don't want to give yourself third degree burns and getting the right temperature is a whole art into itself... but you'll have time to master this art during your recovery! A thermometer would be very useful to avoid burning your butt!
Anyway. This whole experience has been metaphysical for me. Not only I've come to learn a lot about myself, my ability to deal with adversity and have now developed a very healthy dose of sympathy for my patients in pain, I've also developed some philosophical insight about life. Basically, where there's hope on the other side of adversity, we can all get through it. When you know what you go through will eventually be rewarded and things will be fine again, then the struggle is not as horrible and life is worth living. For those of you about to have this procedure, make sure you do your research, find a good surgeon (colorectal surgeon) with a lot of experience in this area, have a loving family member and a support system who will care for you during the first week or two. And know the recovery is not easy. But also know that the there's light at the end of the tunnel and things will be back to normal before you know it. It' just two-three weeks. Then it's all kittens, roses, and butterfly kisses. Well, maybe not those. But your ass will thank you, and you'll be once again grateful to your ass and the service it renders seamlessly when you sit down, when you go to the bathroom, and when you just don't have to think about it again! Then you'll have a new outlook on life and are hopefully a better person because of it.
I wish you all good luck.
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Well, I just wanted to add this note because it's been nearly two months post surgery. The whole experience feels like a distant past and somewhat faded in memory. All that I have now is the perfect results of the surgery. While during that time I would have never said the procedure is worth it, I can now say my being back to who I was many years ago and never having to think twice about my BM and habits again is well worth the two weeks of experience I went through. I'm now a big proponent of the surgery provided that one has enough symptoms that surgery is warranted. I tell you... I can't remember when things were this good! :)
Best of luck to anyone considering this procedure.
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Hi,I have been reading all your messages,I had my hemorrhoidectomy just one month ago and I still have chronic pains when I go to the
toilet!!! I've been told to take pain killers,pain still is there even taking 1000mg every 4 hours!!!! Baths helped a bit in the first place but it just so tiring to keep having to do it all the time!!!! I have been at work for 3 days for only 4 hours but cannot even manage that!!!
Something is wrong but no one knows what it is.... Going to my GP in 3 days cannot wait for a solution... I'll let you know if a solution is found.
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Thanks for sharing your story. No one in my life can relate or understand what I am experiencing. I had this procedure 3 weeks ago. oh the agony. I can walk around again but become very weak. I was already a petite woman but now I look anorexic. Even with the hems I could pass big stools. Now I can barely get any out. The little that does come out is so painful I'm in tears from both pain and frustration. Why is the sphincter muscle so small afterwards and does it ever go back to normal? I seriously cant afford to lose anymore weight. The dr. doesn't believe I have an issue just because he could fit a thumb in my rectum. I am stressed about the bms and almost scared to eat, fearing them. What can I do to open that muscle and what do u think about stool softeners. PLEASE HELP
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Thank you Allen. I am 29 years old and have been diagnosed with hemorrhoids since about the age of 12 due to genetics. At the age 19 I decided to become a Stone Mason. Not a good profession for the hems! For the last 18-24 months, I have been passing considerable amounts of blood every single day with every BM, with massive external and internal hemorrhoids, I finally had enough. Reading your post has been the best piece of advice, encouragement and hope I have found. I am on day 8 postoperative and I am still experiencing horrific pain during Bm. I am going to give the Flexoril a try. The Valium that I am on now for muscle relaxation is not working so well with my mental state. It is true, anyone who hasn't gone through the traditional Hemorrhoidectomy really can not fathom the the pain levels involved. Like you said in your post, I as well, was not thoroughly informed on what to fully expect after the surgery. I was told 5 days of severe pain, then its much better from there on out, I said to myself, eh, I can put up with this for a few days not problem... So far not true. I am still waiting to see a light at the end of this tunnel and put this entire experience behind me. I know for a fact that I will be a changed man after this is all done. This has been the most humbling and mortal experience of my life. I have my post op appt. monday, I will repost any changes incase my situation is helpful to any others. Good luck to ya'll and lets get through this!
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Thanks very much Allen.
Like many others it appears i suffered considerable unnecessary and prolonged pain because the post operation medication and advice given me was not sufficient. I will also pass on your medication recommendations to my surgeon and GP so that future patients of theirs might be spared much agony.
Garry
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hi all,
Well I'm a day short of six weeks since I had the hemorrhoidectomy and delorme's procedure. Reluctant to express discouraging information because anyone reading about these procedures needs hope, reassurance and sound advice that helps them recovery. So I will do my best to put a positive spin on my experience.
For reasons unknown to me, my surgeon and/or his recptionist did not automatically book me in for a post surgery review-at any time. Given what i now understand about the seriousness nature of these procedures, the patient's trauma and the risks and possible complications, it should be mandatory for the specialist to conduct a post surgery physical review at weeks 2, 4 and 6. so my advice is book these appointments when you book in for the surgery. If the specialist won't agree, go to someone who will. It might seem over the top but such appts are much more easily cancelled if not necessary than they are to obtain (even begging doesn't work!!!) if you need some urgent help or reassurance all is recovering well. And almost certainly, you will want some assurance if not some more technical help or advice. Don't accept the specialist saying your general practitioner can help you and review things at weeks 2,4 and 6. The reason the GP referred you to the specilaist is becuase the GP doesnt know enough about all this stuff so how tcan they help ýtou and provide reassurance etc.?!!!
Before you have any of these procedures, book in and obtain help from a physiotherapist who specilaises in pelvic floor and related areas. Despite what the medicos claim, hemorrhoidectomies and similar procedures will upset the tone, balance and functioning of your pelvic floor muscles and how your body manages its bladder, bowels and other plumbing works. Very useful if you have a professional and experienced qualified person assess your starting point in these areas pre surgery. This way you have reliable data about the mayhem done by the surgery and consequecnes of the pain, cramps and spasms that occur post surgery. This means post surgery the physio can assess and identify which things to target to aid recovery. AND if you are really lucky, they may identify a problem that if rectifed, may mean you can avoid having a hemorrhoidectomy or similar procedure.
Lastly, find out from the physio how to poop correctly and try and perfect your technique prior to surgery. From what I have read in many blogs, advice lines , professional literate and reports, most people do NOT poop correctly .
The causes include poor technique, poor posture, insufficient daily exercise, poor diet and insufficient fibre and water intake. And it is almost certainly a major cause of you needing to have a hemorrhoidectomy. And believe me, you only ever want to have a hemorrhoidectomy once in a lifetime and better still not at all.
Hopefully, I will have happier tail and tale to report soon.
Well I'm a day short of six weeks since I had the hemorrhoidectomy and delorme's procedure. Reluctant to express discouraging information because anyone reading about these procedures needs hope, reassurance and sound advice that helps them recovery. So I will do my best to put a positive spin on my experience.
For reasons unknown to me, my surgeon and/or his recptionist did not automatically book me in for a post surgery review-at any time. Given what i now understand about the seriousness nature of these procedures, the patient's trauma and the risks and possible complications, it should be mandatory for the specialist to conduct a post surgery physical review at weeks 2, 4 and 6. so my advice is book these appointments when you book in for the surgery. If the specialist won't agree, go to someone who will. It might seem over the top but such appts are much more easily cancelled if not necessary than they are to obtain (even begging doesn't work!!!) if you need some urgent help or reassurance all is recovering well. And almost certainly, you will want some assurance if not some more technical help or advice. Don't accept the specialist saying your general practitioner can help you and review things at weeks 2,4 and 6. The reason the GP referred you to the specilaist is becuase the GP doesnt know enough about all this stuff so how tcan they help ýtou and provide reassurance etc.?!!!
Before you have any of these procedures, book in and obtain help from a physiotherapist who specilaises in pelvic floor and related areas. Despite what the medicos claim, hemorrhoidectomies and similar procedures will upset the tone, balance and functioning of your pelvic floor muscles and how your body manages its bladder, bowels and other plumbing works. Very useful if you have a professional and experienced qualified person assess your starting point in these areas pre surgery. This way you have reliable data about the mayhem done by the surgery and consequecnes of the pain, cramps and spasms that occur post surgery. This means post surgery the physio can assess and identify which things to target to aid recovery. AND if you are really lucky, they may identify a problem that if rectifed, may mean you can avoid having a hemorrhoidectomy or similar procedure.
Lastly, find out from the physio how to poop correctly and try and perfect your technique prior to surgery. From what I have read in many blogs, advice lines , professional literate and reports, most people do NOT poop correctly .
The causes include poor technique, poor posture, insufficient daily exercise, poor diet and insufficient fibre and water intake. And it is almost certainly a major cause of you needing to have a hemorrhoidectomy. And believe me, you only ever want to have a hemorrhoidectomy once in a lifetime and better still not at all.
Hopefully, I will have happier tail and tale to report soon.
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Thank you for this!!!!! Am going in for procedure in 5 days and this was invaluable!! Will be printing it up & giving it to my surgeon.
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Great you found this information useful. I'm exactly 9 weeks post surgery and waiting to see a pelvic floor specialist. She is going to do some biofeedback computerised assessment of my bm procedure. Reason is i've had constant bowel urgency since the operation. And i mean URGENCY - like 2 seconds notice to get to a toilet. Luckily ive just made it, although some very very close calls. The other problem is having 6, 7 or 8 bms a day, all producting two little suasages about the same lrngth and circumference as a little finger. Sometimes i have really long ones that are almost reaching the water in the toilet before freeing themselves. But mostly dear little sausages.
Another major concern is the almost involuntary spasm/cramp/strain to produce these poops. This scares me because straining can produce haemorrhoids and rectal prolapse and i never want another surgical intervention on my butt.
Another major concern is the almost involuntary spasm/cramp/strain to produce these poops. This scares me because straining can produce haemorrhoids and rectal prolapse and i never want another surgical intervention on my butt.
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Thanks so much. I have just had my procedure last Friday, and it is now 7 days later. Still some ache in my butt but my third BM 4 days after the surgery....I thought someone was going to tap me on the back and say..."it's a boy!!!" THAT BAD. I have since been drinking prune juice and stopped taking the painkillers due to possible constipation, and eating fibrous foods, fruits, and veggies. Doctor did not provide or tell me about a stitz bath but....working without one. Thanks for showing me light at the end of the tunnel. I still dread my BM's but I know that if I keep to the plan, they will never be as bad as the one on my 4th day of recovery.
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Wish I had seen this prior to my surgery! Oddly, my surgeon did not prescribe any antibiotics following surgery. I was in such a fog, I didn't think of it. Anyway, the first 3 days were uncomfortable but not impossible; passing the gauze was a treat but then I was hit with spasms so bad I was howling like a wounded animal. My doctor prescribed Dilauded which did nothing. Following 3 days of excruciating pain---spasms up the sphincter, urgency for bm that produced little nuggets--I headed to the ER. They put me on the same drug in an IV 2 hours apart for 3 days. It quelled the pain but the bms were still not where they should have been. 4 weeks later, the same spasms returned and the same straining for non-productive bms. Doctor ordered an MRI that revealed significant swelling (his rectal exam the day before did not reveal swelling nor could he feel the spasm)further up and an infection, which is strange because I had no fever and my urine tests were all clear. My pelvic floor has been completely out of whack and I've had to self-catheterize, a most unpleasant experience especially in the throes of spasm.
I am now on Levaquin and Fagyl as of yesterday. The major spasms have subsided but I still cannot stand for more than 2-3 minutes without the major bowel pressure and sense of urgency, all for naught. Hoping that the antibiotics and Motrin will bring both the swelling and infection under control. I just want to be able to walk around and get back to my normal routine. I head back to work next week and would prefer to do so without adult diapers!
Also, I suffer from IBS, so be sure you CAREFULLY introduce that fiber into your diet. All the doctors and posts pushed the fiber element, but doing so left me with additional discomfort and pain due to my IBS' sensitivity to fiber, resulting in bloating, cramping, distended abdomen. Tread lightly!
Final note: be sure your surgeon sends you home with preventative antibiotics and do not think that you will be out of the woods less than 4 weeks from the surgery.
As for the hemorrhoidectomy itself, the surgical site feels so much better than it was --before the surgery it felt like I had a cluster of grapes back there all the time. Good luck to you all!
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Guess what, I will gladly take this 2 weeks of pain than to suffer through this. I had both internal and external hemorrhoids and eventually it became so painful that I could barely walk. The doctor looking at my misery immediately asked me to prepare for Hemorrhoidectomy. Boy I am so glad I had the procedure. I was in extreme pain for the first 4 days after the surgery. Pain killers did not help because that caused constipation further complicating the bowel movement after surgery. Hence I endured through the pain and finally I felt so good to be hemorrhoids free that it was all worth it. I was back to normal activities in about 10 days. And for those considering having Hemorrhoidectomy, just go for it because that's the best treatment possible. Rest all are just temporary measure and will never cure hemorrhoids completely.
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Hi. I'm a 39 year old healthy male and am 2 days post op from a hemorrhoidectomy where 3 internal (grade 3 and 4) and 1 large thrombosed external were removed. I have to be honest that I was absolutely TERRIFIED of doing this surgery and tried everything imaginable to avoid having to do it and waited YEARS!!! The pain the first night was unimaginable...I couldn't sleep from it but then slept the following morning as I was exhausted from the pain. After that started doing LOTS AND LOTS of Sitz baths and laying in the tub. the hot water helped a lot and please make use of that. The surgeon also said aleve twice a day is a lot better than ibuprofin but of course everyone is different so please follow your doctor's orders.
Yesterday was ok....but still needed the percocet to get through the pain though tried not to. I called my surgeon who said "take the medication and keep drinking plenty of water and fiber supplements" This morning was different. Woke up with a little pain but took 2 aleve and felt better. Was able to shave, shower, and get cleaned up. I had a phenomenal surgeon who's one of the best colon-rectal surgeons in the country. If you do this surgery it really does make a difference regarding your surgeon. First make sure the surgeon is a specialist and then make sure that they have a great reputation...makes such a huge difference I can't even tell you!
As I mentioned I'm 2 days post op as of right now and am just waiting to have my first BM. I've read lots of posts and many of them have suggested trying to do your first BM in a sitz bath as the warm water helps with the pain and stinging.
Please know my thoughts are with you all and I posted this as a "light at the end of the tunnel" Please feel free to reply to me with any questions.
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