What to Expect After Anal Fissure Surgery

Side-Effects of Fissure Surgery

After a surgery, you can experience some side effects that are mostly temporary. It is recommended that you discuss the side effects with your surgeon before the surgery. The surgery doesn’t normally cause too much pain afterwards. You might experience soreness for some time, but once the wound heals, often within fourteen days, this goes away. You will have some bruises around your wound, but this doesn’t require treatment. Your recovery will entirely depend on the form of surgery that was performed.

Activity

You can slowly resume normal activity after surgery. You should start walking the night or morning after surgery and gradually increase how far you walk according to your personal ability level. Increased activity minimizes chances of blood clots and helps breathing, preventing risks of contracting pneumonia.

The type of surgery performed will dictate your sitting limitations or the distance you can walk. A donut pillow will minimize pressure on the area the surgery was performed.

• Don’t drive while taking narcotic pain drugs as they can impair your driving ability. Only drive after finishing the course of drugs. 
• You will be able to resume normal duties within one to four weeks after the surgery, depending on which type of surgery was performed. 
• Change position regularly. Lying down will relax and reduce pressure on the perianal area. Avoid lying on one spot for very long.
• Remember not to ignore your surgeon's instructions. Stay active but avoid weight lifting and other vigorous exercises. Take normal showers and abstain from sex while healing until the pain goes away.

Pain Relief

• To relieve pain, take medicine every 3 – 4 hours as recommended.
• Apply the cream both inside and outside your anus every 2 – 4 hours as required.
• To control pain, you can bath in plainn, hot water for 20 minutes, three times a day. There is no limit to how long you should soak.
• Expect the pain to go away within 7 – 14 days after undergoing the surgery.

Wound Care

It is vital to keep the wound area dry and clean after the surgery.

Take sitz baths three times in a day or after bowel movement. One has to sit in warm, soapy water for effective cleaning. Hand-held showerheads with nozzles come in handy for this. Taking showers after bowel movements is very effective. Use baby wipes or moist toilettes to avoid incisions and skin irritation in the anus area.     

• Stool leakage and mucus or bloody drainage will be witnessed during the first few days after the anal surgery; this only lasts for a week or two. To protect your clothes, place gauze or any absorbent material - like sanitary napkins - over this area. Although rare, long-term stool might be witnessed after a sphincterotomy procedure.
• Undress the wound the morning after your surgery and get into a warm bath tub.
• After every hot bath, use Silvadene cream on your anus for the first ten days.
• After showering, always pat the area dry; a hair dryer can also be used.
• After every bowel movement, softly cleanse using water to maintain a clean area.
• If you were instructed to use gauze pads around the wound, do so several times during the day. Tuck the gauze evenly to cover the entire surface.

Bowel Movements

• Pain relief drugs may result in constipation, and more pain will be experienced when passing hard stool. Use a stool softener along with pain relief drugs like Colace. It should be taken twice a day.  
• Fiber supplements like fibercon, metamucil, Citrucel, Konsyl, and any other generic brand are also recommended, as the package directs. Make sure you drink 6 – 8 cups of water or any other uncaffeinated beverage every day.
• Unless your surgeon has approved it, don’t use enema.
• If you skip two days without bowel movement take a spoonful of milk of magnesia. Take it after eight hours if you haven’t had any bowel movement. If there are no results after 3 days, take 4 tablets of dulcolax orally altogether. Consult your surgeon after 12 hours of no results.
• 6 – 8 cups of water should be consumed daily. This helps soften one's bowel movements. A high fiber diet is recommended to prevent anal fissure reoccurrence. If high fiber foods had been recommended to medically treat your fissures, stick to that diet. Consult your dietician to familiarize yourself with foods and fruits with a high fiber content.

Bleeding

• It is normal to bleed after every bowel movement. However, if your bleeding continues an hour or more after bowel movement or the bleeding consists of blood clots, inform your surgeon immediately.

Urinating

• It can be difficult to pass urine after your surgery. Straining while urinating won’t hurt the area that has been operated on. If you are unable to urinate, try urinating while taking a warm bath or in a sitting position for men. If you still can’t urinate, 12 hours after your surgery pay the emergency department a visit. Catheter can be inserted in your bladder to assist in emptying it. You should not extend your wait for more than 12 – 18 hours.

Home Medication

Unless instructed otherwise, you are to resume your normal home medications the evening or the next morning after your surgery.

Call Your Surgeon If:

• You develop a fever higher than 101 F. This could indicate an infection.
• There is redness at the area of your incision. This could indicate a skin infection.
• There is drainage within your incisions, especially if it has a foul smell and is thick. This could indicate a deep infection.
• You experience vomiting, nausea or bloating.
• Your pain becomes worse or your pain medication cannot relieve your pain.
• You experience severe or continued bleeding.
• Your system is not producing urine as it was before the operation.
• You develop serious inflammation in the legs or sudden breathing problems. This could indicate blood clots.
• You experience chest pain and breathing problems.

Complications

There is a possibility of developing an infection after surgery. A minor abscess will arise on or near the wound. You will feel pain when sitting down or when opening your bowels. This happens to approximately two in every one hundred persons after the surgery. The infection will normally be treated using antibiotics or through draining that abscess.  

Around 1 in every 100 people develop anal fistula again after a surgery. The channel between one's skin and anal canal is known as the anal fistula. Abscesses that don't heal properly cause recurrence. The fistula is normally small, but surgical procedures can treat it.

Bowel movement can be hard to control after the surgery. This can result in incontinence. This occurs in less than 5 people per 100. It is likely to occur if you happen to have undergone a sphincterotomy. Usually this happens when your sphincter muscles were overstretched or injured when the procedure was being performed. You will most likely experience some problems controlling wind, and also notice liquid stool or mucus soiling your underpants.     

6 in every 100 persons experience fissure again after surgery. Consult your doctor if a fissure occurs again. Alternative medical treatments or further surgery might be recommended by your doctor. More tests can be also be carried out. Chances of developing another fissure may develop if the second fissure is undiagnosed.