![]() ![]() Groups of normal submucosal vascular beds composed of supportive connective tissue, smooth muscle, and blood vessels surround the anal canal. Approximately 2 to 3 cm above this is an anatomical landmark known as the dentate or pectinate line, which is distinguished by a circular row of glands that secrete mucus that acts to lubricate the anal canal. The anal opening is also referred to as the anal verge. However, at least 50% of people will have experienced hemorrhoidal symptoms by the time they reach the age of 50 years. The number of people with hemorrhoids is impossible to determine, as many who experience the symptoms consider them too embarrassing to share with a physician or pharmacist. Unfortunately, many patients who initially seek relief through the use of a nonprescription product will require referral to a physician. 1,4,5 Some persons may put off a pharmacist or physician consultation until the symptoms become unbearable. 1-3 Anorectal problems such as hemorrhoids cause untold misery for many people at one time or another. You will be given more information if this is scheduled.Hemorrhoids are swollen veins in the anal canal that cause a variety of symptoms. The procedure is called flexible sigmoidoscopy, and it may be performed 6 to 12 weeks after your hemorrhoid procedure. Your doctor may want to examine your colon for coexisting disease. Do not place anything in the rectum, such as an enema, for 3 weeks after the procedure. Remove all reading materials from the bathroom. Do not sit for long periods on the toilet. Straining at stool should be avoided after hemorrhoid treatments. These products can initially produce gas and bloating but can be easier to tolerate if the stool softeners are used simultaneously at the start (1 tablespoon daily in a large glass of orange juice, then slowly increase the amount according to package directions). Take a stool-bulking agent such as Metamucil or Citrucel every day. Take over-the-counter (nonprescription) stool softeners such as Colace or Surfak (2 capsules 2 times a day) for at least the first 2 weeks after the procedure. Drink at least 6 full glasses of water daily. ![]() It is very important that your bowel movements remain soft after surgery. After 1 week, some people prefer to use medicines such as Anusol or Preparation H to soothe the tissues. ![]() Twenty-minute sitz baths (soaking in a tub of warm water) can be taken during the first few weeks after the procedure to aid in healing and to provide comfort at the site. Call your doctor if the site develops redness, foul-smelling drainage or swelling, or if you have increasing discomfort in the area. However, you can apply antibiotic ointment to the site daily during the first week after your surgery. Infection is uncommon after this procedure. If you have heavy bleeding, contact your doctor. Even with soft stools, some tearing of the stitches at the surgical site may occur during the first few weeks after the procedure. You can place new gauze over the wound, if you desire, whenever the gauze becomes soiled. You may have some bloody drainage or mild bleeding with passage of stools for the next few weeks. Narcotic pain relievers, such as codeine, are not recommended because they can cause constipation, and hard stools can cause tearing in the anus after the procedure. Take the ibuprofen with food to limit stomach upset. Pain may be relieved by taking a combination of acetaminophen (brand name: Tylenol), in 325-mg tablets, 2 tablets every 4 hours, and ibuprofen (brand names: Advil, Motrin, Nuprin), in 200-mg tablets, 4 tablets 3 times a day. You will probably have some discomfort once the numbing medicine wears off.
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