Instructions for Home Care After High-Resolution Anoscopy

Diet

• Follow a low-roughage diet for 5-7 days. Avoid insoluble fiber, such as raw vegetables and fibrous fruits like pineapple.
• Avoid constipating foods for 5-7 days.
• Then transition to a high-fiber diet.
• Drink plenty of fluids, including 64 ounces of water or other non-sugary fluids daily.
• After your first bowel movement, add a soluble fiber supplement, such as Konsyl, Benefiber, Metamucil, psyllium, or similar fiber.
• Take 1 dose per day, even while on the low-roughage diet.
• You may increase this slowly by 1 dose every 3-5 days as needed.
• Go slowly to allow time to adjust and to avoid abdominal cramping and bloating.
• Goal: soft, formed stools that pass easily.

Activity

• At least 30 minutes of light physical activity daily is recommended.
• Avoid heavy lifting greater than 15 pounds or straining for the first week after the procedure.
• Do not use suppositories, have anal intercourse, or insert anything anally for at least 4 weeks after the procedure.

Toilet Habits

• Sitz baths 2-4 times daily may help with cleansing and pain relief.
• Sit in a warm tub bath, with or without Epsom salts, for 10-20 minutes.
• You may use a hand-held shower attachment, bidet, or squirt bottle of warm water instead of a tub bath.
• Pat dry afterward.
• If you are unable to cleanse with water, use unscented baby wipes for cleansing after bowel movements.
• Pat dry afterward.
• Avoid straining.
• Avoid sitting on the toilet for long periods. Do not read, play on the phone, or remain seated longer than needed.
• It may help to elevate the feet and knees during bowel movements with a small stool or Squatty Potty.
• If you have difficulty urinating, sit in a warm bath and attempt to urinate. If unsuccessful for 6 hours or you feel uncomfortable, go to the emergency room for evaluation.

Bowel Function

• Take a stool softener, such as docusate, Colace, Dulcolax, or generic equivalent, 100 mg 1-2 times daily, especially after hemorrhoid surgery.
• Stop if you have diarrhea.
• After your first bowel movement, add a soluble fiber supplement, such as Metamucil or Benefiber, 1 tablespoon daily.
• If there is no bowel movement in 1-2 days, take mineral oil, 1 tablespoon daily, to ease passage of bowel movements until bowel function resumes.
• Stop if you have diarrhea.
• Take simethicone, such as Gas-X, 80 mg every 6 hours if needed for gas pains.
• If you tend to be constipated or become constipated after surgery, take prune juice daily or MiraLAX 17 g, 1 capful daily, until bowel function resumes.
• Stop if you have diarrhea.
• If there is no bowel movement despite using the above medications for 2-3 days and you feel constipated, you may take Dulcolax laxative tablets and/or Milk of Magnesia according to instructions until regular bowel habits resume.
• If there is still no relief, take MiraLAX 1 capful, 17 g, every 20 minutes until constipation resolves, up to 10 doses.
• If that does not work, take 1 bottle of magnesium citrate.
• Repeat in 6-8 hours if needed.
• If you have taken all of these without effect, please call the office or go to the emergency department for further evaluation.

Wound Care

• Keep a pad or absorbent gauze over the anal area to absorb drainage.
• Change the pad or gauze 1-2 times daily or whenever wet or dirty.
• Some tenderness or pain at the biopsy sites is normal.
• Some bleeding or mucus discharge can be normal.
• Severe bleeding is rare, but can happen.
• If you are going to the toilet frequently to pass blood or clots, saturating dressings requiring frequent changes, or becoming lightheaded or dizzy, please call the office or go to the emergency room for further evaluation.
• You may use diaper rash ointment, such as A&D or Desitin, or a gentle moisturizer, such as Aquaphor, Vaseline, or cocoa butter, on the external skin if needed to soothe and protect the area.

Pain Control

• Take Tylenol 650 mg every 6 hours as needed for pain relief.
• Prescribed pain medication may contain Tylenol, also called acetaminophen.
• Do not take more than 4000 mg of Tylenol or acetaminophen in 24 hours.
• You may take ibuprofen 400 mg every 6 hours as needed for pain relief.
• Take ibuprofen with food to avoid stomach upset and ulcers.
• Do not take ibuprofen if significant bleeding occurs.
• Sitz baths are typically very effective for pain relief.
• A warm pad or ice pack may also be applied for 10 minutes at a time if helpful.

Medications

• Resume all home medications as previously prescribed.
• Do not take Plavix, Coumadin, Eliquis, or other blood thinners for 5 days unless otherwise directed by your physician.

When to Call the Office or Seek Evaluation

Please call the office or go to the emergency department for further evaluation if you develop:

• fever greater than 101°F
• unbearable rectal pain
• increased swelling
• nausea or vomiting
• constipation not relieved with medication
• a large amount of rectal bleeding
• shortness of breath
• chest pain
• leg pain or swelling
• difficulty urinating

Request an Appointment
Call Now

Biopsy Results

The office will typically have results from any biopsy in 1-2 weeks and will call to notify you of results and next steps.

Related Patient Instructions

• Post-Operative Instructions
• Rectopexy Post-Op Instructions
• Cholecystectomy Post-Op Instructions
• Hernia Repair Post-Op Instructions
• Hidradenitis Suppurativa Groin Surgery Post-Op Instructions
• Patient Instructions