Hemorrhoidectomy, the surgical removal of hemorrhoids, is sometimes necessary when conservative treatments fail. Recovering from this procedure requires careful attention to diet and activity to ensure proper healing. This article provides comprehensive dietary recommendations for patients recovering from hemorrhoid surgery, covering what to eat, what to avoid, and how to gradually return to a normal diet.
Initial Post-Surgery Diet: Focusing on Low-Fiber, Low-Residue Foods
In the initial days following a hemorrhoidectomy, bowel movements can be painful. Therefore, the primary goal is to avoid passing large or hard stools. A low-fiber/low-residue diet is often recommended to limit the amount of undigested material passing through the digestive system.
Examples of low-fiber/low-residue foods to eat after hemorrhoid surgery include:
- Strained vegetable juice
- Potatoes without the skin
- Soft-cooked vegetables
- 100 percent fruit juice
- Canned fruits
- Soft melons
- Bananas
- White bread
- White rice
- Pasta
- Cornflakes
- Soft-cooked meat, poultry, and seafood
- Milk and milk products, in limited amounts
Foods to temporarily avoid may include:
- Seeds
- Nuts
- Raw or dried fruit
- Whole-grain breads and cereals
- Foods high in fat
Gradual Reintroduction of Foods
The average recovery time following a hemorrhoidectomy is typically two to four weeks. It's essential to follow your doctor's advice regarding your diet, including how and when to add foods back to prevent discomfort as you continue to heal.
Long-Term Dietary Strategies: Emphasizing Fiber Intake
Once you've fully recovered from hemorrhoid surgery, your diet should include enough fiber to counteract constipation, a significant cause of hemorrhoids. Fiber, found in plant foods, adds bulk to stools, making them easier to pass.
Benefits of a High-Fiber Diet:
- Reduced straining during bowel movements
- Improved regularity
- Decreased risk of developing hemorrhoids
- Feeling full longer
- Improved heart health
- Improved blood sugar control
- Lower cholesterol levels
- Potential protection against some cancers
Recommended Fiber Intake
The Academy of Nutrition and Dietetics (AND) recommends that adult women aim for about 25 grams of fiber per day, while men should aim for about 28 grams, or 14 grams for every 1,000 calories consumed.
Read also: Hysterectomy Diet Guide
Excellent sources of fiber include:
- Fruit: Kiwis, raspberries, strawberries, pears, and oranges
- Vegetables: Broccoli, spinach, carrots, and potatoes with the skin
- Grains: Brown rice, quinoa, whole-wheat bread, and barley
- Beans, peas, and lentils: Kidney beans, chickpeas, and split peas
- Nuts and seeds: Almonds, peanuts, sunflower seeds, and flaxseeds
When increasing your fiber intake, do so gradually, adding one new high-fiber food at a time. Too much fiber too quickly can lead to gas, bloating, and constipation.
The Role of Hydration
Adequate water intake is essential when increasing fiber consumption. Water helps to keep things moving, preventing constipation and promoting regularity.
Fiber Supplements: An Alternative Option
While obtaining nutrition from whole foods is generally preferred, fiber supplements can be a viable option if meeting your fiber needs through diet alone is challenging.
Additional Foods to Consider
Patients recovering from hemorrhoid surgery should focus on the following foods to promote healing and reduce complications:
Fiber-Rich Foods
Fiber-rich foods promote digestion and help reduce bloating and constipation. Fiber is divided into two types: soluble fiber and insoluble fiber.
Read also: Fundoplication Diet Guidelines
- Soluble fiber: Transforms into a gel-like substance in the body, found in fruits and vegetables such as dragon fruit, spinach, and jute mallow.
- Insoluble fiber: Does not dissolve in liquids in the digestive system, found in whole grains, leafy greens, nuts, and fruits like apples, avocados, and strawberries.
Adequate Water Intake
Water enhances the efficiency of fiber in the gut. Proper hydration softens stools and makes bowel movements easier. Patients recovering from hemorrhoid surgery should drink plenty of water, fruit juices, and vegetable juices. It is recommended to drink 2-2.5 liters of water daily. For those who are physically active, a higher intake may be necessary. Additionally, starting the day with a glass of warm water can improve digestive function.
Foods Rich in Omega-3 Fatty Acids
Omega-3 is essential for healthy skin and the mucous membranes of the intestines. It also has anti-inflammatory properties, which help reduce swelling after hemorrhoid surgery. Omega-3 can be found in seeds like flax seeds and chia seeds, as well as in cold-water fish.
Foods High in Vitamins C and E
- Vitamin C: Supports the formation and maintenance of healthy blood vessels, preventing potential diseases. It is abundant in fruits and vegetables like strawberries, guavas, kiwis, oranges, broccoli, and papayas.
- Vitamin E: A fat-soluble vitamin vital for cell membranes, it reduces inflammation, heals tissues, and shrinks hemorrhoids, alleviating swelling after hemorrhoid surgery. Foods rich in vitamin E include chestnuts, spinach, kale, papayas, and avocados.
Foods High in Magnesium and Zinc
Magnesium and zinc are crucial for stabilizing blood vessels, improving bowel regularity, supporting muscle tissue growth, reducing inflammation, and healing wounds. After surgery, patients can consume foods rich in magnesium and zinc, like dark chocolate, avocados, whole grains, raisins, and seeds. If needed, supplements can be taken under a doctor’s guidance.
Green Leafy Vegetables
Green leafy vegetables or cruciferous vegetables are the best foods for piles after surgery as they have rich content in nutrition, antioxidants and fibre which is good for stomach health and digestion.
Fresh Fruits
Fresh fruits along with their skin have a rich source of fibre, vitamins, and minerals. Eating fresh fruits can be healthy and the best food to eat after piles surgery.
Read also: The Role of Serum in Skincare
Whole Grains
Whole grains like bran cereals, oatmeal, brown rice, multigrain bread, etc are the best foods to eat after piles surgery.
Sprouts
Sprouts are rich in vitamin C, proteins, fibres, and calcium. The presence of the nutrients in the sprouts can be an effective and best food to eat after piles surgery in order to treat piles. Eating a cup of steamed or boiled sprouts every day can help in managing irritation of the bowel.
Curd or Buttermilk
Curd or buttermilk is one of the best foods to eat after piles surgery because they are rich in probiotics to enrich gut microbes and promote a healthy digestive system.
Foods to Limit or Avoid
Patients with hemorrhoids or those recovering from hemorrhoidectomy should limit the following:
- Refined grains: Processed grains with the bran removed can cause constipation, aggravate hemorrhoid symptoms, and make bowel movements painful.
- Meat: Although rich in protein, meat lacks fiber and can cause bloating and indigestion. Excessive meat consumption may lead to constipation. To regulate a reasonable diet, people with hemorrhoids and those who have just had hemorrhoid surgery should limit meat consumption. Meat can be processed with green vegetables and healthy fats for easy digestion, limiting constipation.
- Spicy foods: To avoid making hemorrhoids worse, patients should limit spicy foods. Spices like chili, pepper, ginger, and mustard can increase body heat, elevate blood pressure, and cause sweating. Overconsumption may result in internal heat, constipation, and pain during bowel movements.
- Salty foods: High-sodium foods can harden stools, making bowel movements more difficult and uncomfortable for people with hemorrhoids and those who have just had hemorrhoid surgery.
- Sugary and starchy foods: Consuming too much sugar and starch can strain the intestines, causing constipation, anal itching, and worsening hemorrhoid symptoms.
- Oily foods: Foods high in oil may cause bloating, indigestion, and digestive disorders, increasing the risk of constipation.
- Alcoholic beverages and stimulants: This group of drinks causes internal organs to accumulate heat or cause bloating, and dehydration, causing dry stools and constipation. At the same time, they damage the rectal mucosa, causing congestion and impeding blood circulation.
General Recovery Expectations
After hemorrhoidectomy surgery, you can expect some degree of:
- Bleeding: Some bleeding after a hemorrhoidectomy is normal, especially after having a bowel movement (pooping). You might see blood in your stool or on your toilet paper. You might also see some in your underwear, along with some clear or yellow discharge. You can wear a sanitary pad or gauze to help soak up the fluid. This can last for up to a month. It shouldn’t be a lot of blood. It’s possible to split the wound open if you strain too hard to poop, which could cause more severe bleeding. It’s important to avoid constipation to prevent this. Rarely, some people experience a postoperative hemorrhage, acute bleeding from the blood vessels that were cut in surgery. If you bleed a lot, call your provider.
- Swelling: Swelling after a hemorrhoidectomy is normal. Swelling inside your anus can feel similar to hemorrhoids. You may feel like they’re still there or think they’ve come back, but this isn’t the case. Sometimes a lump or a skin tag will develop at the site of the wound, which can also be deceiving. These generally go away once you’ve healed. Healing time varies for everyone. You can help reduce the swelling by applying ice wrapped in a towel to the wound a few times a day for 10 minutes at a time. It also helps to lie on your stomach with a pillow supporting your hips. See if you can sleep this way.
- Pain: You can expect some pain after a hemorrhoidectomy, and the pain levels people report are relatively high. But you should be able to manage your pain with medications. Healthcare providers usually offer a variety of strategies for managing pain, including oral and topical medications and gentle wound care. To get ahead of the pain after your operation, start your medications before you start to feel it. Most people say the pain is gone after two weeks. See your provider if your pain lasts longer than two weeks, if you’re having trouble managing your pain or if your pain is preventing you from peeing or pooping.
Pain Management
Healthcare providers assess post-hemorrhoidectomy pain using a visual analog scale (VAS). It rates pain on a scale of one to 10, with 10 being the worst. Pain ratings range from moderate to severe.
Pain is very subjective, and people can experience it differently. There’s not always an apparent reason for this. However, you may be more likely to experience more pain if you have:
- A preexisting disease.
- An infection.
- Constipation.
- Emergency surgery.
Typically, the most significant pain occurs with your first bowel movement after hemorrhoidectomy surgery. Pain usually improves after three days and continues to improve for the next two weeks.
Strategies for Improving Pain
Healthcare providers continue to explore new strategies for reducing post-hemorrhoidectomy pain. Some research suggests that people experience less post-hemorrhoidectomy pain with:
- Electrosurgery: Using electrothermal and cautery devices for cutting and sealing the tissues and blood vessels appears to result in faster healing with less pain after surgery.
- Local anesthesia: Anesthesia applied directly to the site of the surgery, combined with other types, appears to result in less postoperative pain.
- Methylene blue: Injection of a blue dye surgeons sometimes use can improve pain at the site of the surgery as a side effect. Methylene blue has a temporary numbing effect on the nerves.
- Topical GTN ointment: GTN ointment (glyceryl trinitrate) is a prescription medication that reduces muscle spasms in your anus. It also improves blood flow and promotes faster healing.
In addition to the care you receive from your healthcare provider, you can also improve your pain levels and healing time by taking good care of yourself at home. Your provider will advise you on self-care.
Managing Bowel Movements After Surgery
Pooping can be painful after a hemorrhoidectomy, especially the first time. It gets easier as you heal. You can improve your pain levels and your healing time by preventing constipation and straining.
Healthcare providers suggest that you:
- Gradually add fiber to your diet: Try eating high-fiber foods or take fiber supplements.
- Avoid spicy foods: Spices can burn on the way out.
- Drink plenty of water: Hydration is essential, especially as you add more fiber to your diet.
- Try unfiltered apple juice or prune juice: These have natural laxative properties.
- Use laxatives as needed: There are several types. Ask your provider what they advise.
- Don’t read on the toilet: Sitting on the commode too long is associated with constipation.
- Use a step stool: Elevating your feet helps position your hips to make bowel movements easier.
- Use gentle wipes: Baby wipes or medicated pads can help protect your tender tissues.
- Use topical anesthetic: Apply lidocaine cream to help numb your wound before pooping.
Promoting Wound Healing
Healing from a hemorrhoidectomy takes time, but you can help the process along by taking good care of your wound and your body during your recovery. For aftercare, healthcare providers recommend:
- Sitz baths: Soak your bottom in 3 or 4 inches of warm water a few times a day.
- Ice: Apply an ice pack wrapped in a towel to your wound for 10 minutes a few times a day.
- Medications: Your provider will suggest a combination of oral and topical pain medications.
- Rest: Don’t push yourself too hard to go back to your usual activities. Give yourself time to heal.
- Preventing constipation: Use every trick in the book if necessary.
Lifestyle Adjustments for Preventing Recurrence
- Maintain hygiene: Cleanliness of the anal area is essential.
- Avoid Straining: If you experience difficulties during evacuation, breathe deeply and relax.
Resuming Normal Activities
After you have hemorrhoids removed, you can expect to feel better each day. Your anal area will be painful or ache for 2 to 4 weeks. And you may need pain medicine. It is common to have some light bleeding and clear or yellow fluids from your anus. This is most likely when you have a bowel movement. After 1 to 2 weeks, you should be able to do most of your normal activities. Rest when you feel tired. Be as active as you can. It can help prevent problems and help you recover. For 2 to 3 weeks, avoid lifting anything that would make you strain. You may take showers and baths as usual. You will probably need to take 1 to 2 weeks off work.
Additional Post-Operative Instructions
- You may begin eating and drinking as soon as you get home from surgery. You may eat a regular diet as tolerated. It is very important to avoid constipation during the recovery period. Therefore, you will be placed on a high fiber diet or should take a fiber supplement such as Metamucil or FiberCon.
- As soon as you reach home, you may resume normal ad lib activity. You are encouraged to begin walking and resuming household activity as tolerated immediately. Going up and down stairs is also ok. You should refrain from engaging in any strenuous activity such as running, riding a bike, heavy exercising in a gym, etc. for at least 2-3 weeks. You should also avoid any heavy lifting greater than 20lbs. for 2-3 weeks. After that, you may resume any activity as tolerated.
- You will have a gauze dressing around your anus after surgery. This can usually be removed by the following day and left off. An ice pack can help reduce swelling. Soaking in a sitz bath (a shallow bath of warm water) several times a day helps ease the discomfort. Using a donut ring (cushion with a hole in the middle) can make sitting upright more comfortable.
- A small to moderate amount of bleeding, usually when having a bowel movement, may occur for a week or two following the surgery. This is normal and should stop when the anus and rectum heal.
- You may resume all your normal medications after surgery except for aspirin or other anticoagulants. You should wait at least 1 week after surgery before beginning aspirin or other anticoagulants.
- You will experience the most intense pain for several days after the surgery. It may last up to 10 days after the surgery. You will still be sore after that for up to 3-4 weeks after the surgery. You will most likely be sent home with a prescription for narcotic pain medications. Use the narcotics as directed on the prescription. You may take less than what is indicated on the bottle, but not more. Be sure to take narcotic pain medication with food so as not to upset your stomach. You may begin to taper your narcotic medication as tolerated and discontinue them as soon as possible. As you are tapering off the narcotics, you may transition over to Ibuprofen. You should not drive or operate any mechanical equipment while on narcotic medications.
- It is not unusual for patients who have been through surgery, a general anesthesia, and who are taking narcotics to become constipated. It is very important after a hemorrhoid surgery to avoid constipation. You will be sent home on a high-fiber and high liquid diet. You will also be sent home on stool softeners such as Colace or Sennekot. If you need something more than this to avoid constipation, you may need to take over-the-counter oral laxatives such as Milk of Magnesia or Magnesium Citrate. You should stay away from rectal suppositories or laxatives. You should stay regular and have a soft bowel movement every day.
- Because of swelling and the dressing, some patients have temporary difficulty urinating. If there is urgency, but the urine will not flow, a catheter is used to empty the bladder. Outpatients may need to stay overnight, if they are unable to urinate.
tags: #post #haemorrhoidectomy #diet #recommendations