On Bowel Movements after Hemorrhoid Surgery
For me, the key to keeping out of pain after surgery is figuring our proper 'stool maintenance'. I have figured out a few things that I'll share. (by the way, I've written a blog about my ongoing recovery from surgery you can read here - http://www.healthboards.com/boards/blog.php?u=778387)
1. Get on stool softeners pre-surgery.
I started taking Colace (docusate sodium 100mg), about 3 days prior to surgery. I started out at 2 tablets in the morning and 2 at night. Since having the surgery, I upped the dose to 3 tablets, morning and night.
I also learned prior to surgery, that Colace on it's own wouldn't do it. So I added 1 packet of Miralax around mid-day.
You will have to figure out the amounts of each that are appropriate for you, but this is crucial to keeping your pain levels manageable.
2. Drink LOTS of water.
I got home from surgery at 5pm. Between then and bedtime, I had drank 100oz. This wasn't enough. The next day, I drank a total of 100oz. This too... not enough. The next day also 100oz. Again, not enought. How do I know? CONSTIPATION on Day 3-4. By the way, I'm 5'8", 160 lbs and ordinarily, this is PLENTY of water. Now, I'm up to 160oz per day and this is working well. I drink a 20oz glass when I wake up, and another within 90 minutes of rising. Then keep that up throughout the day.
3. Don't get constipated!!
Remember, whatever painkiller you're on will constipate you. It does this by slowing down perastalsis (the natural muscular movement of food through your small/large intestines). Since the food spends more time in your digestive tract, it loses more moisture, turning your normally soft stools into little compact rock-hard pellets that when combined together, can form a large stool that is EXTREMELY painful to pass (this happened to me on the 2nd day after surgery).
For me, this meant 6 bowel movements, about 2 hours apart for about 12 hours. During each, out came a bunch of little pellets... but I could feel the impacted mass in my colon. Here are the 2 things I did that finally gave me relief.
A. Mineral Oil Enema. Yes, this probably sounds horrible. Anything touching your anus at this point sounds horrible. But I found that it wasn't as bad as it sounds. And, it was MAGIC! FANTASTIC! I haven't seen anything written about them on the message boards and I don't know why. I had my mom by 3 of them just so I have them on hand for bowel emergencies! You want to get all of it in, and then keep it in there for at least 20 minutes (if possible). This will lubricate things and help them come out. By the way, had I known about this earlier, I might have been able to prevent the 12-hour constipation ordeal I went through.
B. Milk of Magnesia. This helped with the first and subsequent bowel movements. I took 4oz. Probably too much. In hind sight, I would have taken 3oz.
4. Soaking in the Bathtub.
I don't exactly know what it is, but every time I've struggled with a bowel movement (and sometimes even when I haven't), I get in the tub, soak for at least 30 minutes, and a bowel movement comes - usually while I'm soaking in the water. Gross, right? Well, given the alternative (extreme pain and suffering), I haven't really cared about 'gross'. Bring the poop! In fact, I think I've probably pooped more in volume in the bathtub in the days following my constipation than I have in the toilet.
5. As an absolute LAST resort, I had my mom pick up a bottle of Magnesium Citrate. This is what they use to get your colon cleaned out prior to a colonoscopy. I've been told (never done it) that after taking the Magnesium Citrate, its not a pleasant elimination experience. It can be accompanied by cramping, nausea and violent bowel movements. That's why I say it's a LAST resort. Remember that the poop MUST come out. If this doesn't work, the only thing left to do is to go to the emergency room where they manually get it out of there.