Hemorrhoids are swollen veins inside or
outside the anus. They may be caused by
increased pressure, such as straining when
having a bowel movement or pregnancy.
Hemorrhoids can cause pain, bleeding,
clots, and itching.
Buy these a few days before surgery:
1 bottle Magnesium Citrate – 10 oz.
2 sodium phosphate enemas
The Day before Surgery
Eat a light breakfast and lunch.
Avoid greasy foods and red meat.
Drink only clear liquids (no pulp, no
dairy) after lunch.
o Water, sparkling water, soda
o Juice with no pulp (apple, grape)
o Popsicles- no fruit fiber
o Gatorade G3 Recover /silver label
Bottle only (+ protein)
o Jell-O (no fruit in it) NO Jell-O
o Coffee or tea, no creamer
o Crystal Light
o Ensure Active Clear
After lunch, do not eat food; do not drink
juice with pulp, dairy products, or alcohol.
_____ 2:00 pm drink magnesium citrate 1
bottle. It is okay to drink this
earlier. Drink this once you are
home to stay for the day. It tastes
best if chilled. Magnesium citrate
may give you loose stools and some
cramping. It could take 30 minutes
to 8 hours for results. You may have
bowel movements for hours after
_____ You may want to give yourself the
first of two enemas this evening.
Take the second one in the morning,
1 hour before you leave for the
hospital. See below.
_____ Shower before bed and in the morning
before leaving home.
The day before surgery, clear liquids
onlyafter lunch. Nothing to drink the last
4 hours before surgery.
The Day of Surgery
_____ 1½ hours before you leave home, give
yourself the first enema. Give yourself
the second enema ½ hour later.
Take a sitz bath at least three to four times a
day and after each bowel movement (BM)
for several days. This can be done in two
ways. Sit in bathtub filled with 3-5 inches
of warm water. Add nothing to the water.
Relax for at least 10-20 minutes. OR you
can use a plastic tub that you place on your
toilet. Sitz baths help you heal, and lessen
the pain of rectal spasms. For comfort, you
may want to sit on a towel in your bathtub.
Avoid toilet paper. Instead clean the area
after a BM by spraying with warm water.
We will give you a spray bottle or you may
want to use a hand held shower. Gently pat
dry with a baby wipe, (free of perfume,
dyes and alcohol).
You will have yellow-red drainage for at
least 7-14 days. Expect to wear pads (free
of perfume and dyes) in (cotton) underwear
(best to use fragrance and dye free detergent)
to monitor drainage. Change pads every 4
hours or as needed to limit wetness and to
help prevent itching in this area. You may
see more bloody drainage with increased
activity and BMs. You may have swelling at
the anus with tissue protruding from anus.
You may also have lump or skin tags
develop around the anus. This is your
body’s reaction to the incisions made at
surgery. These lumps will shrink as recovery
Plan for rest during the day. Expect
to be up and around doing light
duties each day to keep up your
Chang position often for comfort.
Do not drive while taking narcotic
Sex may be resumed when it is
okayed by your doctor.
Check with your doctor before you
return to work. Your recovery time
may be longer if your job involves
lifting or sitting.
After surgery, you will have pain. With
banding, expect to have rectal pressure. At
first, you will feel numb in your rectal area.
You may be able to get home with no
narcotic pain pills. Once you are home, you
may want to take a dose of pain pills before
you lay down for your nap. You do not want
pain to wake you up. If it does you may have
waited too long. You will need to take your
narcotic pain pills before you have pain and
schedule them for at least the first 1-2 days.
The person staying with you overnight will
need to set an alarm and check on you
during the night. It is very important that the
pain does not wake you up. Schedule your
pain pills. Always take them with a small
snack. Stay ahead of the pain for the first
few days. On the pain scale
0-10, 10 is the worst, expect that your pain
will be at 5-6 out of 10. This is a reasonable
pain goal. Do not drink alcohol, drive a car,
or use heavy machines while you are taking
This is a common course of pain after this
The first 5 days you will have a lot of
Expect to have pain with your first
BM. Do not hold off on having a
BM. Follow the urge to go when you
If you had banding, the bands fall off
day 3-10. Expect that you will bleed
and have more pain. You may need
narcotic pain pills again.
If you have stitches, they dissolve in
10-14 days. You will bleed and have
more pain. You may need narcotic
pain pills again.
After 5 days you may have less pain.
It is normal to see blood on your
stool for weeks after surgery.
Buy the stool softener, docusate sodium.
Take at least 2 each day. Take these as long
as you use the narcotic pain pills and until
you have your first BM. This will help stool
pass more easily. Follow package
Buy a bulk fiber laxative, such as
Metamucil®. If taken every day, it can
prevent hard stools. Take it at least once a
day, at the same time every day. Follow
package directions. Do not start until after
you have had your first bowel movement.
Drink at least 8 glasses (8 ounces each) of
fluid each day to stay well hydrated. This
helps you heal faster, helps your pain pills
work better and can help prevent
constipation. Drink enough fluid so that the
color of your urine is light yellow or clear.
You may want to eat a soft or liquid diet
until you have your first BM. Once you
have your first bowel movement, you may
want to add other foods to your diet. Avoid
spicy and acidic foods as you heal.
When to Call the Doctor
Large amounts of bright red blood
from the rectal area that does not
stop with firm pressure to the rectal
area for 10 minutes
Temperature greater than 100.4 θ F,
take your temperature daily for one
Excess swelling in the rectal area
Problems passing urine
Digestive Health Center: (608) 890-5000.
After hours, weekends or holidays this number will be answered by the paging operator. Ask
for the doctor on call or ask for Dr. Harms, Heise, Kennedy, Foley or Carchman. Leave your
name and phone number with area code. The doctor will call you back.
If you live out of the area, call (855) 342-9900.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 11/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4461