Surgery is a radical treatment for hemorrhoids. Nowadays, many conservative therapies for this disease have been developed. However, in advanced cases it is impossible to do without surgical intervention. How is recovery after surgery? Hemorrhoids is a chronic disease prone to recurrence. What rules and restrictions must be observed to prevent the re-formation of hemorrhoidal nodes? We will consider these issues in the article.
How is the operation
An operation to remove hemorrhoids is called hemorrhoidectomy. It is carried out in the late stages of pathology, when conservative therapy no longer helps. There are several varieties of this surgery:
- Operation Milligan - Morgan. This is the most common type of hemorrhoidectomy. The surgeon removes not only hemorrhoidal nodes, but also areas of the skin and mucous membrane around them. Bleeding is stopped with a laser or electrocoagulator. This intervention is carried out in an open way, that is, without suturing. Excised areas heal naturally.
- Ferguson's technique. The technique of this operation is similar to the previous one, but the intervention is carried out in a closed way. After excision of nodes and nearby tissues, sutures from catgut are placed on the wounds. Subsequently, the threads dissolve on their own.
- Parks operation. This is the most gentle surgical intervention. With this operation, the surgeon excises only hemorrhoidal nodes, but does not affect the mucous membrane. Intervention is carried out using an electric or laser scalpel. Soreness after such manipulation is practically absent.
- Longo method (stapler operation). Such an intervention is effective for minor lesions. During this operation, the excess part of the mucosa is incised and pulling out the outgoing nodes. Sutures are applied using a special stapler. As a result, the blood supply to the nodes is disturbed, and they decrease.
- Harness (Subbotin operation). During this operation, the knot is not excised, but bandaged with a special ring. This leads to a violation of the blood supply and self-falling node.
Each patient needs to find out from the doctor: how the operation was performed. The features of the rehabilitation period will depend on this.
Rehabilitation Duration
How long is the recovery period after surgery? Hemorrhoids are removed by various methods. The duration of rehabilitation depends on the invasiveness of the surgery:
- Milligan-Morgan technique. This is the most traumatic way of surgery. Complete healing of excised areas occurs only after 2 months. During the recovery period, it is necessary to adhere to many restrictions in lifestyle and nutrition.
- Operation Ferguson. The closed method of operation is considered more sparing than the open. The recovery period takes from 14 to 30 days.
- Minimally invasive techniques. This type of intervention includes operations according to the method of Parks, Longo and Subbotin. Usually they do not require a long stay of the patient in a hospital. Full recovery of the body takes no more than 7-14 days.
The ability of tissues to regenerate is individual in different categories of patients. The duration of rehabilitation after surgery depends on the speed of wound healing. Hemorrhoids can be completely cured only if the patient complies with all the rules of asepsis and uses special disinfecting ointments and suppositories. As a rule, in young patients, the mucosa is restored faster than in the elderly.
Possible complications
What could be the consequences after surgery to remove hemorrhoids? Most often, such surgical interventions are successful. However, many patients in the first time after surgery complain of the following unpleasant symptoms:
- Pain in the anus. Unpleasant sensations are especially pronounced with the open method of intervention, when the wounds heal on their own. This often worries patients with a low pain threshold. Indeed, in the area of the anus there are many nerve endings. In this case, it is necessary to stop the discomfort with the help of painkillers.
- Problems with urination. These manifestations more often concern male patients. Some patients experience urinary retention after surgery. This is especially often observed with the epidural method of anesthesia. In this case, doctors insert a catheter into the urethra. This usually fixes urine excretion problems.
- Bleeding. This symptom is often observed with small wounds in the rectum. Damage usually occurs during the passage of feces of solid consistency. In such cases, doctors recommend taking laxatives. Hemorrhoids after surgery can be complicated by prolonged and persistent bleeding. In this case, you need to visit a proctologist.
- The delay of the chair. Constipation after surgery most often has a psychogenic origin. Patients are afraid of pain and avoid timely bowel movements. In no case should this be done. After all, feces can accumulate and create a serious problem with emptying. This leads to the formation of wounds and cracks.
- Purulent inflammation in the suture area. This consequence occurs due to non-observance of personal hygiene, especially after visiting the toilet. Hemorrhoids after surgery are often complicated by inflammation of the rectum. In advanced cases, the infection can go to the area of the large intestine. This is due to neglect of necessary hygiene procedures. Therefore, washing the anal area should be carried out after each bowel movement. If suppuration has occurred, then it is necessary to treat the wound with local antiseptics. In severe cases, the abscess must be opened.
How to avoid unpleasant consequences after surgery to remove hemorrhoids? Next, we will consider in more detail the features and rules of rehabilitation.
Physical activity mode
When can I return to my previous physical activity after surgery? How to prevent a relapse of hemorrhoids? What to do after surgery if it was performed in an open way? These questions are of interest to many patients.
If the operation was successful, then the doctors allow the patient to get out of bed on the second day. The patient may also walk a little. But to be in a sitting position is allowed much later, not earlier than 7 days after removal of hemorrhoids. You can crouch only when postoperative pains completely disappear. It is recommended to use a pillow or an inflatable circle for sitting. Such devices are needed in the first 2 weeks. Sitting on a hard surface is highly undesirable.
On the second day after surgery, it is recommended to do light gymnastics. Exercises are performed lying or standing. In this case, you can not load the abdominal muscles. You can do sipping, turning from side to side, small movements with arms and legs, as well as breathing exercises. This will help prevent venous complications, which are often noted in elderly patients.
Avoid being seated or upright for a long time. The body needs moderate movement. Periodically, you need to change the position of the body, otherwise blood stasis in the abdominal cavity may occur.
In the first 14 days after surgery, weights must not be lifted weighing more than 2 kg. Classes in the gym can only be renewed after 3 months. At the same time, strength exercises should be excluded forever, since excessive overstrain can provoke a relapse of the disease.
How to relieve pain
Often patients complain of discomfort in the first time after surgery to remove hemorrhoids. Pain after surgery can last from 3 to 10 days. In such cases, the use of non-steroidal anti-inflammatory drugs is indicated:
These medicines are prescribed as oral tablets. In severe pain, injectable forms of drugs are used.
Local suppositories and ointments are also prescribed after surgery to remove hemorrhoids:
- Anestezol;
- "Aurobin";
- Relief Advance;
- Proctosan
- "Procto Glivenol".
These drugs have a local anesthetic effect and help to quickly stop the pain syndrome.
It is important to remember that analgesic drugs should not be taken continuously. They are intended for symptomatic treatment; they should be used only for pain. Otherwise, the body may become accustomed to the action of analgesics and anesthetics, and large doses of drugs will be required to achieve the desired effect.
In some cases, doctors recommend applying cold compresses to the exit area of the rectum. This helps to narrow the vessels and reduce pain.
Postoperative Wound Healing
In many cases, doctors use an open method of surgical intervention to save the patient from hemorrhoids. What to do after surgery to prevent infection of the wound and restoration of the mucosa?
It is important to remember that with this method of operation, the wound is healed on its own, since suturing is not used. Therefore, it is necessary to use the following wound healing preparations:
- Candles "Anuzol". These are rectal suppositories based on belladonna extract in combination with bismuth and zinc salts. They have astringent properties and contribute to the healing of postoperative wounds. Also, this drug acts as an antiseptic and analgesic. It is important to remember that suppositories "Anuzol" are contraindicated in patients with weak intestinal motility.
- Sea-buckthorn oil candles. These suppositories disinfect wounds and contribute to the rapid regeneration of the mucosa.
- Candles "Natalsid". These are suppositories based on seaweed extract. They promote healing of cracks and prevent inflammation.
- Ointment "Levomekol". The composition of this tool includes the antibiotic chloramphenicol, which has an antibacterial effect, as well as the substance methyluracil, which improves tissue nutrition. The drug acts as an antiseptic and wound healing agent.
- Ointment "Solcoseryl". This drug is made from the blood of cattle. It improves tissue metabolism and stimulates the production of collagen fibers. This helps the speedy healing of excised areas.
It is necessary to complete the course of treatment with wound healing ointments and suppositories after surgery. Hemorrhoids can reoccur if a wound in the rectum becomes infected or poorly heals.
Taking laxatives
To minimize injury to the rectum, it is necessary to take drugs to soften feces. Firm feces can injure the mucous membrane of the anus, which often causes inflammation and pain.
It is necessary to use laxatives and ointments after surgery. Hemorrhoids often recur due to systematic constipation. The use of local funds based on glycerin is shown:
- Norgilax;
- Glycelax;
- "Glycerin."
Do not use laxatives that irritate the intestines. They can cause mucosal damage and bleeding.
If local laxatives are ineffective, then prescribe drugs for oral administration:
- Senade;
- Dufalac
- Normase
- Guttalax.
Laxatives should be taken only as directed and as directed by your doctor. Overuse of such drugs can lead to impaired intestinal motility.
In order to prevent constipation, you must also adhere to a diet. The nutrition rules after hemorrhoidectomy will be discussed later.
Diet
Patients who have undergone surgery should take food at least 5-6 times a day. Food should be consumed in small quantities; overeating can lead to constipation. A day you need to drink at least 2-2.5 liters of fluid.
It is necessary to eat such products that do not cause constipation and the formation of solid feces. This will help to avoid complications of hemorrhoids. What do they eat after surgery? Proctologists recommend the following products in the diet:
- Vegetables: cabbage, zucchini, beets, carrots, tomatoes. These foods are rich in fiber and contribute to easy bowel movements.
- Fruits and berries: apples, oranges, pears, strawberries, peaches, apricots, dried fruits. They also help soften stools.
- Dietary meat: chicken breast, turkey fillet, rabbit meat. These products will help to saturate the body with proteins. Meat should be boiled or steamed.
- Low-fat fish species: pollock, hake, pike, zander. Such food contains many useful trace elements, which help the healing of the mucous membrane. Fish, like meat, must be boiled.
- Dairy products. Patients are advised to use kefir, fermented baked milk, yogurt, cottage cheese, yogurt. These products prevent intestinal dysbiosis.
- Porridge. It is recommended to eat dishes of buckwheat, oat and millet.
- Vegetable oil. This product is recommended for dressing vegetable salads. Vegetable (especially olive) oil facilitates bowel movements.
- Whole grain products. In the period after the operation, the use of flour products is limited. They must be replaced with whole grain bread, preferably white. This product will help fill the deficiency of B vitamins.
You should avoid eating solid and indigestible foods with hemorrhoids. In the diet menu after surgery, you must regularly include mashed and chopped vegetables in a fresh and boiled form. The use of such food minimizes trauma to the lower intestine.
The following foods should be completely excluded from the diet:
- canned food;
- salted vegetables and mushrooms;
- fried foods;
- fatty meat and broths;
- meat, fish and vegetable semi-finished products;
- meat and fish smoked meats;
- any fast food;
- dishes of pearl barley, rice and pasta;
- spicy seasonings;
- black bread;
- sweets;
- baking;
- ice cream;
- Legumes
- nuts
- strong black tea;
- coffee.
Patients are strictly forbidden to drink even low alcohol. Violation of this rule can lead to bleeding from the anus, constipation, and subsequently to relapse of hemorrhoids.
Observe food restrictions for at least 2 months after hemorrhoidectomy. However, many proctologists recommend that patients follow a diet for life. Such a healthy diet serves as a good prevention of relapse.
Hygiene
As already mentioned, it is very important to prevent infection of wounds during the treatment of hemorrhoids. Recovery after surgery should include not only the use of antiseptics, but also strict observance of personal hygiene. Otherwise, wounds in the rectum can become inflamed and suppurate.
It is necessary to adhere to the following hygiene rules:
- The anus should be washed in the morning and evening, as well as after each bowel movement.
- In the first weeks after surgery, do not use toilet paper. After defecation, you need to wash the anus with clean water. After wound healing, wet wipes can be used.
- Washing should be carried out very carefully so as not to injure the mucous membrane.
- After hygienic procedures, the skin should be wiped with a soft cloth or napkin. Do not use a rough and stiff towel.
- To wash, you need to use liquid soap or a special gel for intimate hygiene.
- The patient should always have wet wipes soaked in an antibacterial composition.
For pain and inflammation in the anus, it is useful to wash yourself with decoctions of anti-inflammatory herbs: chamomile, hypericum, oak bark. You can also do sitz baths with herbal remedies. However, you can use such folk remedies only after consulting a doctor.
Relapse prevention
In most patients, surgery to remove hemorrhoids leads to a complete recovery. Most often, after surgical intervention, patients have persistent remission. However, this does not exclude the possibility of recurrence of the disease. In some cases, hemorrhoidal nodes re-formed in patients several months or years after surgery. Doctors distinguish the following causes of relapse of the disease:
- frequent constipation;
- passive lifestyle;
- weight lifting;
- violations of the diet during the rehabilitation period;
- alcohol consumption.
We can conclude that the re-formation of hemorrhoidal nodes is most often associated with violations of the rules for the rehabilitation period. If the patient complies with all the doctor's recommendations during recovery after surgery, then relapses are extremely rare.
Reviews
Patient feedback on recovery after surgery suggests that rehabilitation takes on average about 1.5–2 months. Subject to all the recommendations of doctors, no negative consequences of hemorrhoidectomy in patients were noted.
Most patients successfully completed the recovery period. After surgery, hemorrhoids no longer recurred. Surgical intervention has led to persistent remission.
However, if a person prematurely embarked on excessive physical exertion, violated the rules of nutrition and hygiene, then this ended with the occurrence of complications. In such patients, prolonged postoperative pain and bleeding, inflammation in the wound area, and sometimes prolapse of the rectum were noted. In these cases, patients had to undergo repeated treatment in a hospital setting.
Therefore, one should not rush to start a familiar lifestyle shortly after surgery. Hemorrhoidectomy is a difficult operation. It is necessary to give the body time to fully recover, and only after that proceed to the usual physical activities and diet.