Unlike a rubber band ligation that can be done in an office setting, a hemorrhoidectomy is a surgery that is done in a hospital. As a general surgeon, knowing how to prepare patients for a hemorrhoidectomy is critical to their care and wellbeing before, during, and after the procedure.
Begin A Bowel Prep
24 hours before a hemorrhoidectomy, it is essential that patients complete a bowel prep. This process is usually done at home with a laxative or an enema and is meant to remove all fecal matter from the colon, making surgeries easier and reducing the risk of infection.
The method of bowel prep can vary from hospital to hospital and procedure to procedure, so be sure to educate your patients on what they should do. Stress to patients that they must complete the prep, otherwise their surgery may have to be rescheduled.
Instruct Patients To Fast
Patients should not eat or drink anything for 8-12 hours before the surgery. This includes chewing gum. Fasting is necessary before surgery to ensure that the bowel prep is not ruined and helps prevent aspiration, nausea, and vomiting.
For their last meal before fasting, instruct patients to go easy and not eat a large meal. Instead, have them eat a light meal of soup or salad, which is quicker for the body to digest. If they have been instructed to take their prescription medication before surgery, they may take it with a small sip of water. If a patient is taking prescription medication, have them bring them with them to the hospital. That way, if they were ordered not to take them before the surgery, they may do so afterwards.
Have Them Get Comfortable
Advise patients to wear comfortable clothes that are easy to get in and out of and to avoid wearing makeup, nail polish (this includes acrylic nails), and jewelry.
The reason patients should not wear makeup and remove nail polish and acrylic nails is that nails are good indicators of a patient’s circulation and nail polish can get in the way of the pulse oximeter. For acrylic nails, patients do not typically have to remove all of them—removing one on each hand is usually fine but this rule varies from hospital to hospital. Likewise, makeup will mask a patient’s natural face color.
Have Patients Bring A Responsible Adult
Because patients will be under anesthesia for the surgery, they will not be allowed to drive home. Have them find a responsible and trusted family member or friend to drive them home and make sure that they follow all post-surgery instructions. That means avoiding heavy lifting, drinking plenty of water and eating healthy, high-fiber foods, and not straining when using the toilet.
Emphasize to patients to contact you and seek emergency medical care if they experience unusual symptoms like:
- Bleeding
- High fever
- Painful urination or unable to urinate
- Severe pain in the stomach or anus
