Surgical Instructions
At Advanced AnoRectal Health, we help patients understand their diagnosis and treatment. In addition to the office visits, we provide a wealth of information to support the discussion face-to-face. Please refer to your detailed instructions given to you in the office and call the office with any additional questions.
| Surgery
Preoperative – Preparing for your procedure
Anesthesia requires a family member or someone you personally know to drive you to and from your procedure. Please make transportation arrangements.
You may be ask to hold certain blood thinning products or other medication(s) prior to your procedure.
As a general rule, you should not eat or drink anything after midnight before surgery. In some cases, you may be allowed to drink clear liquids up to a few hours before your anesthesia. This may seem strict, not being able to have a sip of water or coffee, but this decreases the risk for problems such as vomiting during surgery.
You may brush your teeth and rinse your mouth with a small sip of water, but do not swallow any of it.
If you have been told to take medicine the day of surgery, take them with just a small sip of water.
Stop smoking for at least twenty-four (24) hours before surgery.
Do not chew gum on the day of surgery.
You may be advised to do a bowel prep and/or fleet enema prior to your procedure.
Bathe or shower the day of surgery. Do not wear makeup, lotion, powder, deodorant or nail polish.
Clothing should be loose fitting, comfortable and appropriate for wearing after the procedure you will be having.
You may be asked to remove your glasses, contacts, hearing aids and dentures. Please bring your eyewear case, your hearing aid case and/or a denture cup.
A medical clearance may be required prior to your procedure.
What to expect on the day of surgery
You will be scheduled to arrive an hour or several hours prior to your procedure to allow for any pre-surgical testing to be performed.
You should remove all jewelry prior to arriving to the procedure location.
A nurse will review and have you sign all required pre-surgical paperwork prior to your procedure.
You will be asked to give a detailed health history and family history. This will include any problems with anesthesia and allergies.
If you do not follow instructions about not eating or drinking before your surgery, your surgery may be delayed or even cancelled.
Your surgeon will visit you before starting the surgery to review your procedure with you again and answer any questions you may have.
Things to bring with you the day of surgery
Insurance card(s)
Identification card
Bring a list of all the medicines you are taking, the reason you are taking it, the dose you take and how often you take it. Include prescriptions, over-the-counter medicines, and herbal remedies, recreational drugs, tobacco, and alcohol. The American Society of Anesthesiologists recommends that everyone stop herbal medicines at least two (2) to three (3) weeks before your surgery to avoid the possibility of unwanted interactions and side effects. This information will help your anesthesia provider to select the best drugs for you to avoid the unwanted drug interactions. It is important that you also bring a list of any known food or drugs allergies.
You need to let the nurse know if you have home insulin or pain device including pacemaker and automatic internal compression device (AICD.) This is important to know so we can safely plan your care. If you have your medical device identification card, please bring this the day of your procedure.
Postoperative – what to do after you get home
Pain control during this time is essential, as movement can cause an increase in pain level. Post operative pain is expected and over the counter or prescription pain reliever may be taken to help control the pain. A dramatic increase in pain for no apparent reason should be reported to our office.
Non-steroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen) can be used alone for mild to moderate pain. For moderate to severe pain, NSAIDs are often used in combination with opioids. Please note opioids may cause constipation and having MiralLax® on hand is beneficial.
To prevent post operative complications, it is recommended you a drink plenty of fluids, and up walking at least fifteen (15) minutes of every hour you are awake.
Resume your regular diet unless instructed differently by your surgeon.
Resume your routine medication unless instructed differently by your surgeon.
Blood thinning medication may be resumed 1 week following your procedure unless instructed differently by your surgeon.
Incision care is also important after surgery. Change your bandage once daily or more frequently if soiled to keep the incision area clean. You may start Sitz Baths the day following surgery. The nursing staff will go over all postoperative instructions before you are discharged to go home.
Information following specific procedures
Excision of Thrombosed Hemorrhoid
Rubber Band Ligation of a Hemorrhoid
| Bowel Prep
Distal Prep – a Fleet Enema 1 hour prior to the exam to eliminate stool from the rectum and anus
| Colonoscopy Prep
A full day bowel prep to clean the entire colon, rectum and anus of waste is required for a successful colonoscopy. There are several options the doctor may choose from. Although the volume of water is different for each prep, the instructions for each prep must be followed carefully to prevent dehydration and toxicity. The doctor may choose from the following:
Clenpik
Golytely
Miralax
Suprep
SuTab
Additional Education Material