Hemorrhoidectomy Recovery: Timeline, Home Care, & What to Expect

Hemorrhoidectomy is a surgery used to treat hemorrhoids when symptoms are severe or conservative treatments fail to provide relief. Hemorrhoid surgery recovery takes time and requires changes in diet and activity to help you heal properly. Pain medications and stool softeners may also be involved.

Preparing for hemorrhoid surgery can cause stress, but knowing what to expect during recovery can help ease the anxiety. Fortunately, hemorrhoidectomy has a high success rate.

This article explains what is involved in the recovery plan for a hemorrhoidectomy, including the expected timeline and home care treatments that promote healing and prevent post-surgical complications.

Hemorrhoid Surgery Recovery Timeline

Recovery from hemorrhoidectomy can last anywhere from four to eight weeks. The timeline varies based on the size, severity, and number of hemorrhoids you have as well as your general health and mobility level.

For the first week or two, you need to take it easy, staying at home and avoiding strenuous activities, including heavy lifting.

After one to two weeks, you should be able to return to normal activities. However, you still need to avoid activities that require a lot of effort.

You can expect some pain and discomfort for two to four weeks following the surgery, though it will gradually subside. You can minimize pain by avoiding constipation, practicing proper wound care, and using pain medications as prescribed.

Full recovery with no pain is usually achieved within one to two months.

Home Care

You can make recovery from a hemorrhoidectomy a whole lot easier by educating yourself and making a few preparations in advance of the surgery. This includes restricting certain activities, preparing meal plans, having a pain management strategy, and committing to follow-up appointments.

Activity

Certain activities need to be restricted during recovery from a hemorrhoidectomy. These include any activity that places undue pressure or movement of the anal sphincter. This is the ring of muscles that dilates (opens) and contracts (shuts) to enable the passage of stools. Rapid or extreme movement of the anal sphincter can disrupt stitches and open the wound.

Especially during the first weeks of recovery, you need to avoid the following:

• Heavy lifting
• Straining during bowel movement
• Running
• Heavy exertion of any sort

You also need to avoid sitting for long periods without movement. In fact, it actually helps to walk during early recovery. Doing so increases circulation and prevents the pooling of blood in the injured tissues.

If you do need to sit, it often helps to have a donut-shaped pillow to sit on. Be sure to get one that is soft and properly sized. One that is too large and hard can cause the buttocks to spread and stretch the anal sphincter.

Diet

The main dietary goal following a hemorrhoidectomy is the avoidance of constipation. Hardened stools place extreme pressure on the surgical site during bowel movements. Most are caused by inadequate fiber intake and dehydration.

During the first few days of recovery, you will need to eat a low-residue diet, consuming foods that place little stress on the anus during bowel movements.

Low-residue foods include:

• Cooked cereals, like farina or cream of wheat
• White rice or noodles
• White bread or plain saltine crackers
• Well-cooked vegetables or canned vegetables without seeds
  
• Lean ground beef, chicken, or pork
• Eggs
• Dried fruits, including prune
• Ripe bananas
• Soft melons or papaya
• Applesauce
  
• Gelatin
• Pudding
• Ice cream or popsicles

As you begin to heal, you can embark on a low-fat, high-fiber diet. This includes foods rich in soluble fiber which draw water out of the intestines and helps soften stools

Sources of soluble fiber include:

• Apples
• Avocados
• Beans and legumes
• Berries
• Brown rice
• Brussel sprouts
• Brocolli
• Carrots
• Cauliflower
• Eggplant
• Pears
• Sweet potatoes
• Zucchini
  

Medications

There are two classes of medications commonly prescribed to people who have undergone a hemorrhoidectomy: stool softeners and analgesics (painkillers).

Stool softeners work naturally with the body to ease bowel movements and have fewer side effects than stronger stimulant laxatives. They are also less likely to cause diarrhea, which also places undue stress on surgical wounds.

Recommended stool softeners include:

• Milk of Magnesia (magnesium hydroxide)
• Colace (docusate sodium)
• Metamucil (psyllium husk)
• Miralax (polyethylene glycol)

Analgesic drugs used to treat postoperative hemorrhoid pain include:

• Tylenol (acetaminophen): An over-the-counter drug that has analgesic and antipyretic (fever-reducing) effects
• Oral nonsteroidal anti-inflammatory drugs (NSAIDs): Options include Advil (ibuprofen) and Aleve (naproxen) which have analgesic and anti-inflammatory effects
• Rectal NSAIDs: Most commonly Voltaren (diclofenac) suppositories

NSAIDs are used with caution during early recovery as they can promote bleeding. The drugs are also intended for occasional, short-term use as they can cause stomach ulcers if overused.

Topical hemorrhoid creams may also be prescribed to relieve itching, while an ice pack or cold compress can be applied to the anus to help ease swelling and pain.

Follow-Up Appointments

A follow-up appointment will be scheduled two to three weeks after your hemorrhoid surgery. It is important to keep the appointment to ensure that the wound is healing properly.

During the appointment, the healthcare provider will examine your rectal area to ensure that there are no complications, some of which include:

• Infection: Recognized by pain, oozing, swelling, and redness of the surgical site
• Anal stricture: The narrowing and hardening of the anal sphincter
  
• Urinary retention: The reduced ability or inability to urinate (pee)
• Fecal impaction: When stools back up into the small intestine
• Fecal incontinence: The loss of bowel control

Additional appointments, tests, or exams may be scheduled.

Things to Avoid

With the proper treatment, you should recover from a hemorrhoidectomy without incident. Here are a few things you need to avoid to ensure a worry-free recovery:

• Avoid foods that cause constipation, such as dairy products, red meat, and processed foods. 
• Don't move quickly or lift anything heavy until your healthcare provider gives you the OK.
• Avoid wiping your anus with dry toilet paper for the first few days. You can instead use unscented baby wipes, Tuck pads, or moistened paper towels.
• Do not apply skin cleansers, antibacterial soaps, alcohol, iodine, or hydrogen peroxide to the rectal area. They can damage the skin around the incision and delay healing.
  

Long-Term Recovery

Continue to eat foods high in fiber even after you have recovered from surgery. Drink plenty of water and avoid straining on the toilet. Doing so can help prevent future hemorrhoids.

Exercise can also decrease constipation by stimulating the bowels. Even a 15-minute walk can help. Twisting exercises and toe touches also promote regular bowel movements.

Not all hemorrhoids can be prevented, but following these simple recommendations can greatly reduce the risk.

When to See a Healthcare Provider

If you follow your surgeon's self-care instructions, the likelihood of infection and other complications is low. Even so, complications can occur, and it's important to know the signs so you can act quickly.

Call your healthcare provider immediately if you develop the following signs or symptoms when recovering from hemorrhoid surgery:

• High fever with chills
• Pain that cannot be controlled with medicine
• Problems passing stool or urine
• Abnormal discharge from the anus
• Passing large amounts of blood from the anus
  

Summary

It can take four to eight weeks to recover from a hemorrhoidectomy, although you should be able to return to work in one to two weeks. During this time, you need to adjust your diet to avoid constipation and avoid activities (like heavy lifting) that can disrupt the surgical incision.

Over-the-counter pain medications and a sitz bath can help relieve pain. Drinking plenty of water and eating a high-fiber diet can keep stools soft and prevent constipation. Stool softeners can also help.

Continue eating a fiber-rich diet with plenty of water even after you've recovered. Along with exercise, these can help keep hemorrhoids from coming back.