The University of Michigan Health System defines an anal fistula as “an abnormal tunnel between the anal canal and the outer skin of the anus.” Fistulas can be quite painful, causing bleeding, itching and pain in the rectum. They are usually the result of constipation. Fistula surgery is sometimes required if the anal fistula does not heal on its own. This surgery is typically an outpatient surgery, so no overnight hospital stay is required. Recovery from fistula surgery can be managed much easier if you follow specific measures to ensure proper healing.
Pain after fistula surgery is inevitable. The first three to five days following the surgery can be especially uncomfortable. Your doctor will likely prescribe pain medication to help get you through the first few days. You may experience nausea and vomiting, as these are common side effects of prescription pain medication. As soon as the pain begins to ease up, try using over-the-counter pain medication rather than the prescription medication.
The bandage that was placed on the incision area should remain on for several hours after you are discharged from the hospital. Take a sitz bath the night of the operation or the next morning. Fill your bathtub with about four inches of warm water and soak for 15 minutes, at least twice daily. You can also purchase bath basins that fit right over your toilet seat for sitz baths. For added relief and healing, you may add a bit of Epsom salts to the bath. Continue twice daily sitz baths for two weeks following the fistula surgery.
You may notice drainage from the incision site, as well as itching. This is normal in a healing fistula. Blood may also be seen in the anal region, especially after bowel movements. Clean the area thoroughly with a moistened wipe. Place a sanitary or gauze pad in your underwear to prevent drainage or blood from seeping through to your clothing. If the bleeding is profuse, this is not normal and you should call your doctor right away.
Although the thought of having a bowel movement after fistula surgery may frighten you, do not resist the urge. It will probably be uncomfortable, but refraining from having bowel movements can cause constipation that will only irritate the anal region further.
Purchase a donut ring from your local drug store or medical supply store. This is a soft cushion with a hole in the center that makes sitting in a chair more comfortable. Strenuous activity should be avoided for at least one week after fistula surgery. You can resume your normal daily activities as soon as you feel comfortable enough to do so.
Avoid becoming constipated so the fistula can heal quickly and properly. Eat a diet high in fiber, consuming plenty of fresh fruits and vegetables. Drink six to eight glasses of water a day. You can also take a fiber supplement, such as Metamucil or Benefiber, to ensure regular bowel movements. Stool softeners can be taken twice daily as well to help prevent constipation.
If you fail to have a bowel movement by the fourth day post-surgery, contact your doctor for specific instructions. He may request that you have an enema or drink milk of magnesia to induce a bowel movement. You should continue to have bowel movements at least every other day.