Principles of management of the postoperative period after plastic vaginal surgeries. Rehabilitation after removal of a hernia of the spine

After surgery to remove the hernia, a period of rehabilitation begins. And this time is the most difficult and responsible for both the patient and the doctors. After all, successful recovery depends not only on the experience of the surgeon, but on the desire of the patient to fight the disease to the bitter end.

Problems in the first weeks

Modern surgery has made some progress. Now, after the removal of a hernia of the spine, the patient does not require long-term hospitalization. The patient goes home for 2-5 days, receiving the doctor's recommendations. During this period, many questions arise that may not be immediately covered. So, rule number one is to have a phone number or other means of communication available to your doctor if you are going home after surgery. This is the key to your peace of mind.

The first weeks of open surgery are very difficult. The patient experiences pain that is not associated with pinching of the nerve, but with surgical procedures. Therefore, in addition to medicines, the patient needs moral support. Family people should rely on loved ones, and lonely people should notify their friends about the operation - someone should be nearby during this period.

Any activity is carried out with the permission of a specialist. Basic rules: minimum loads, their gradual increase, no sudden movements. During operations on the bone part of the spine - strict observance of the requirements of the doctor and instructor in therapeutic exercises.

The initial period is fraught with the appearance of some reactions that bring pain and discomfort, but are not dangerous to health. For example, spinal anesthesia can cause headaches 2-3 days after surgery. The pain syndrome is caused by the loss of CSF through a puncture in the hard shell. To prevent this phenomenon, it is enough not to get out of bed for a day after the operation and drink plenty of fluids. By the end of the week, the patient may experience "old" pain in the back and lower extremity. With hernias of the cervical region, pain radiates to the hand. As a rule, this is not a recurrence of the disease, but postoperative edema. For its relief, analgesics (ketanov, oxyten), drugs for removing fluid (detralex, L-lysine aescinate) are used. By the seventh day of rehabilitation, the symptoms go away on their own.

When should you call the doctor?

1. When the temperature rises. If the numbers on the thermometer are 37.5, this is not a cause for concern. But a fever above 38 indicates the development of a serious complication and requires immediate examination by a specialist.
2. In violation of the function of organs and limbs. Some complications or incorrect actions of doctors can provoke paralysis. If you have these symptoms, be sure to go to the hospital.
3. With the appearance of redness and the presence of discharge in the area of ​​the postoperative wound. Sometimes it is enough to turn to an outpatient surgeon to correct the treatment. But it is better when infectious complications are seen by the operating doctor.

Fixation

Rehabilitation after removal of a hernia is carried out with the obligatory fixation of the problematic department. We will talk about the timing and indications for wearing a corset or orthosis below.

The correct corset is a retainer with rigid metal inserts 30-35 cm wide. It takes on the entire load, supports the muscles of the lumbar and sacral. Recovery of soft and bone tissues will not be complete without such a bandage.

The latch must be put on in a horizontal position. The best option is a corset with additional fixation straps. They allow you to change the tension force of the orthosis. These recommendations are relevant for lumbar disc herniation. What to do during neck surgery? The Philadelphia-type orthosis will help to keep immobility.

You can stand and walk in a corset for a short time. The main rule is to increase the load daily with a long rest. If you start with 15 minutes a day, by the end of the week your vertical activity time should be 35-40 minutes. Between them pauses on a horizontal plane (about an hour).

Wearing a corset does not preclude washing it. Usually in the postoperative period, patients have increased sweating. In this case, stock up on two orthoses.

Exercise after surgery

Exercise therapy during the recovery period is applied from the third day of surgical treatment. Therapeutic gymnastics is performed in the supine position and helps to activate the muscles. Exercises are performed slowly, calmly, breathing should be even (inhale through the nose, exhale through the mouth). Therapeutic gymnastics is performed in 4 poses:

• exercises lying on your back;
• abdominal exercises;
• side exercises;
• quadruple exercises.

The basic rules of exercise therapy during the recovery period: the absence of pain during movement, smooth execution, regularity. So, from the third day, you can do the following exercises:

complex on the back

• arms extended along the body. The palms are facing down. Hands push off from the horizontal plane for 2-3 seconds. Then relaxation. Repeat several times (1-2) daily increasing the number of repetitions to 15. This recommendation applies to any exercise;
• lying on the stomach, we unbend our head, clench our fists and pull the toes of both feet. We return to the original position;
• bend your knees and spread out to the sides. We tilt the knee so as to touch the opposite heel;
• hands are spread out to the sides. We take out the opposite shoulder with the palm;
• we squeeze our palms on our chest in the “prayer” position. We hold the effort for 2-3 seconds;
• brushes "on the castle". Effort unclench the "lock";
• make a bicycle with one foot. The second is bent at the knee. We alternate limbs;
• end with pelvic lifts. Inhale up, exhale down.

Abdominal exercises

Charging in this position is not carried out in the first days of recovery. Exercises are used closer to 3 weeks after surgery:

• arms spread apart, raise one leg up, return to its original position. Repeat with the other limb;
• hands are spread out to the sides. Raise the shoulders and chest. We go back;
• we crawl in a plastunskin place;
• lying on your stomach, raise your knees, using the work of the muscles of the buttocks. The toes of the feet rest on the floor;
• raise your legs bent at the knees. After we straighten the joints. We return to the starting position.

Complex on the side

• the right arm is bent at the elbow and placed behind the head. Left we rest on the floor. We pull our knees in ourselves, straighten our legs again. Next, change sides;
• raise the leg up, first one, then two at once.

Complex on all fours

• with the right knee we take out the left elbow, then we change sides;
• we stretch the right arm and left leg parallel to the body, change limbs;
• we sit on our heels, the back arches.

Sitting problem

Sitting down in the postoperative period should be very careful. After microdiscectomy and laser vaporization of the intervertebral hernia, you can sit in the first hours after surgery. Other surgeries that involve more trauma have different requirements in this regard.

Sitting is only allowed after 3 weeks. You need to sit down only for a short time when getting out of bed. After the third week, you can sit for 15 minutes a day, increasing the time to an hour by the first month. The chair for sitting should have a back and a deflection forward in the lumbar region. In the absence of such a modification, place a roller or rolled up blanket under your back.

Patients spend most of their working time sitting. When going to work, this causes a complication of the disease, as the load on the operated spine increases. To prevent problems, there are a number of simple rules that must be strictly observed:

1. You can not sit for more than 60 minutes. The rehabilitation period ends in 2-3 months. And the patient returns to his usual activities. In order not to provoke a complication after the operation, get up from your chair every 45-50 minutes and do a small set of exercises.
2. You can't drive for a long time. The patient returns behind the wheel only 1.5-2 months after the operation. Take care of the comfort of the chair (roller under the back or orthopedic pads). If you have a long trip, then every hour you need to stop (you can unload your back with the help of charging).
3. Seating positions must have armrests, which should be supported before landing.

Aquatherapy

Swimming is a unique way to tone your back muscles. In water, the load on the spine is significantly reduced. But swimming after surgery on the intervertebral hernia is a lesson for the second month. The patient's rehabilitation potential is higher by this time, and the scar in the back area is fully formed. Therefore, the risk of infection is minimal.

So, what subtleties should be considered when exercising in the pool?

• the postoperative wound must heal completely;
• physical therapy precedes classes in the water;
• an instructor is constantly in the pool with the patient;
• swimming can be alternated with elements of exercises in the water.

Horizontal bar

The rehabilitation period after surgery on the intervertebral hernia lasts quite a long time. After 3 months of the protective regime, you can return to your usual way of life. However, some restrictions remain for life. These include gymnastics on the horizontal bar. Most experts advise to abandon such physical activity with an intervertebral hernia. And after the operation, exercising on the horizontal bar is categorically contraindicated.

Why can't pull-ups be used for muscle rehabilitation after a herniated disc? Few can withstand charging on the horizontal bar. For proper pulling and hanging, you need strong arm muscles. But any activity on this projectile is associated with significant effort and jerk. It is difficult to perform the exercise gently and smoothly without preparation. Sudden movements are strictly contraindicated for sick people. If the patient does not control his spine, then you can get injured or complication of the disease. Therefore, with hernias, avoid horizontal bars, especially if you are overweight.

Mode

• bed until IV-V days. Active movements in bed after 6-8 hours to restore consciousness after anesthesia of exercise therapy from the second day;
• getting up (without sitting down!) on the second day in cases of operations without perineoplasty, on III-V - in case of perineoplasty and / or Manchester operation, taking into account the general condition and well-being of the patient (necessarily in the presence of a doctor - better than a surgeon!). Further on the state of the patient;
• sitting down (not low - on a regular chair - and not for a long time - up to 20-30 minutes) can be allowed on the 7th-8th day up to 4 weeks from the date of the operation. Further normal mode;
• exclude lifting weights in front of you, exercises with a load on the abdominal press and sexual activity for 6 weeks from the date of surgery.

Diet

• I day - table 0, moisten the oral cavity with neutral water;
• II day - table 0, allow drinking (for sweets!) In the desired amount, but in small (50-100 ml) portions, so as not to induce vomiting. Desirable alkaline mineral waters "Borjomi", "Polyana kvasova", after removing the gas (open the bottle for 2-3 hours), infusion of rose hips (1 tablespoon and 200 boiling water without adding sugar);
• III-IV days - (with the appearance of appetite) give liquid and semi-liquid food (mashed vegetable soup, kefir, sour cream, cottage cheese, cookies, apples, butter). Do not give whole milk, canned juices and products not previously consumed by the patient. Disposable food volumes are small (100-400 gr);
• V-VIII days - gradually switch to the usual diet and diet for the patient with the inclusion of products that enhance intestinal motility (prunes, figs, vegetables).

Anesthesia

• drugs and non-narcotic analgesics according to the intensity of the pain syndrome and depending on the type of anesthesia during the operation;
• after epidural anesthesia with morphine on the first day, additional anesthesia is not required (drugs are categorically contraindicated - respiratory arrest is possible!). II-III days to prescribe analgesics with desensitizers parenterally);
• after other options for anesthesia of the operation in the first two or three days, drugs 2 times (morning and evening) and analgesics 2-3 times with desensitizers parenterally:
• from the 4th day, pain relief with only analgesics with a decrease in the frequency of administration. From the 6th-8th days, anesthesia, as a rule, is not required. Those who have undergone levatoroplasty often feel a feeling of tension in the anus (false urge to defecate), which is stopped by tableted non-narcotic analgesics.

Infusion therapy

On the second or fourth day in the morning, intravenously inject crystalloid and colloid solutions (2:1) at the rate of 35 ml per 1 kg of patient weight under the control of CBS and plasma osmolality to correct BCC, electrolyte balance, CBS.

Patient care, perineum and sutures

• put the patient in a pre-warmed (with heating pads) functional bed in the supine position and without a pillow under the head;
• put cold on the perineal area (ice in a small bubble wrapped in a sterile diaper) for 30 minutes after 1.5-2 hours;
• constant observation until the morning of the next day (breathing, pulse, control of wetting the tampon into the vagina). Remove the swab after 12-18 hours. Further observation 4-2 times a day;
• remove urine with a catheter every 6 hours, followed by toileting of the vulva and sutures on the perineum (washing with a solution of furacilin, drying and processing with brilliant green).

During the first two days, stimulate independent urination (by changing the position of the body by dripping water into the vessel, administering pituitrin 1.0 i/m, hexamethyltetramine 400% 10.0 i/v).

When catheterizing the bladder, carefully observe asepsis, dip the catheter in vaseline oil. In cases of prolonged catheterization (more than three days), use uroseptics (palin up to 10 days, 1 capsule (200 mg) 2 times a day after meals or nitroxalin 0.05x2) to prevent and treat cystitis, urethritis:

• toilet of the oral cavity (brushing teeth with toothpaste in the morning and evening), washing, hygienic wiping the body daily;
• prevention of bedsores - massage and lubrication of the back, buttocks and sacrum with camphor alcohol from the second day, frequent changes in the position of the patient in bed;
• from the second day, wash the vagina 1 time daily through a catheter (on a gynecological chair) with 3% hydrogen peroxide solution, 20-40 ml and furacilin solution 1:5000 200-300 ml with the introduction of bactericidal vaginal tablets, suppositories, balls (ginalgin or polygynax) until discharge from the hospital. After discharge, the patient continues douching at home 1-2 times a day until the discharge from the vagina stops.

Removal of perineal sutures on the 6th day (after emptying the bowels the day before).

Before removing the sutures - vaginal examination (with one finger) to exclude the divergence of the vaginal sutures and infiltrates.

Restoration of intestinal motility

• in most cases, it occurs on its own (gas begins to move away on the II-III day, defecation - on the IV-V day);
• after vaginal extirpations and / or initial bowel diseases with increasing flatulence, activate the smooth muscles of the intestines of the patient with oxytocin 1.0 ml / m x 2 in an hour, alternating with cerucal 1.0 / m x 2 in an hour; increase in the tone of parasympathetic innervation with prozerin 1.0 x 2 in an hour. If on the fifth day there was no stool, prescribe laxatives (castor oil 60.0-80.0 ml or saline). Do not use enemas!!!

Antibacterial therapy

• only according to the indications and data of bacteriological analysis and determination of sensitivity to the preparations of the patient's flora, made during the preoperative examination;
• . in cases of urgent and complicated operations (bleeding, phleboctasis, tissue injury), elderly patients, in order to prevent septic complications, sulfaxine is prescribed 2.0 intravenously during surgery, days II and III, followed by the administration of norfloxacin 1 dr. x 2, 5-10 days.

Discharge from the hospital

On days IV-VII after surgery without perineoplasty, on days X-XIV - with perineoplasty under supervision and for rehabilitation in the antenatal clinic at the place of residence.

Criteria for discharge:

• satisfactory condition and well-being of the patient (independent hygienic self-service and walking);
• satisfactory data on hemodynamics, hemoconcentration, CBS, blood coagulation system;
• normothermia,
• absence of suppuration of the wound, infiltrates, thrombophlebitis, phlebitis.

Temporary disability 3-6 weeks from the date of surgery in the absence of complications. Eliminate heavy physical labor up to six months.

Ed. K.V. Voronin

How long hemorrhoids heal, how long the recovery of the body after surgery will last, depends on proper rehabilitation and the patient's compliance with all the recommendations of the attending physician.

Indications for surgical removal of hemorrhoids

To treat hemorrhoids in the initial stages, doctors use complex treatment and minimally invasive procedures to remove inflamed hemorrhoids. Radical surgery to excise the bumps is indicated in the following cases:

• hemorrhoids in the last stage with complications (chronic anal fissures, acute thrombosis of the rectal veins, fistulas, leakage of the contents of the rectum to the outside);
• frequent exacerbations of hemorrhoids, complicated by other pathologies of the rectum (colitis, polyposis, rectal erosion, etc.);
• intense hemorrhoidal bleeding leading to anemia;
• failure of conservative treatment;
• frequent relapses of the disease that occur after minimally invasive procedures.

How long is the rehabilitation period?

The duration of rehabilitation after surgery primarily depends on the method of excision of the nodes. In modern medicine, several methods of conducting surgical interventions to remove hemorrhoids are used:

• open operation of Milligan-Morgan - excision of hemorrhoids, in which the wounds remaining after excision of the nodes are not sutured, but left open. The recovery period lasts 5-6 weeks;
• closed Fergusson surgery - hemorrhoids are also surgically removed, while the edges of the wound are sutured. The rehabilitation period is 3-4 weeks;
• submucosal hemorrhoidectomy according to the Longo method (stapler) - during the operation, the nodes themselves are not excised, a section of the rectum is removed and the bumps are lifted into the anal canal. The recovery period is about 7 days. This method can only be used to remove internal hemorrhoids. The disadvantage of the operation is the high probability of recurrence, compared with other operations.

What factors affect the healing of hemorrhoids?

No doctor can say exactly how long hemorrhoids heal. In each case, the restoration of the body occurs purely individually. The general terms of rehabilitation depend on the complexity of the operation, the complications present at that time, the stage of hemorrhoids, and also on the general condition of the patient.

Any surgical intervention extremely adversely affects the state of any organism, weakens it. For It is important to remember that in addition to jelly, tea and compotes, it is mandatory to drink at least 2 liters of water without gas every day, and all products must be steamed or boiled. Reducing rehabilitation periods and preventing the development of postoperative complications after removal of hemorrhoids should be observed simple recommendations in the daily routine and nutrition, as well as during physical activity.

Diet

Eating on the first day after surgery is not recommended. It is allowed to drink water, jelly, weak tea or plain boiled water. The next day, you can already enter easily digestible foods into the menu. Food should be consumed in pureed form, in small portions 5-6 times a day.

Products should be easily digestible and should not cause fermentation and increased gas formation in the intestines. Dishes in the menu of the postoperative patient should not be the cause of difficult defecation. Violation of the stool can cause deep infection of the tissues and damage the stitches.

Diet

In the postoperative period, special attention should be paid to proper nutrition. A properly composed daily menu will help speed up the recovery process after hemorrhoid removal. To do this, it is necessary to introduce foods rich in vitamins and antioxidants into the diet.

The menu of the postoperative patient should include the following products:

• vegetables: carrots, beets, zucchini;
• fruits and berries: oranges, bananas, melons, blueberries;
• meat: boiled veal, chicken;
• cereals: oatmeal, buckwheat;
• fermented milk products: low-fat yogurt, kefir;
• drinks: kissels, compotes, black tea without sugar, you can add chamomile, rose hips to tea.

It is important to remember that in addition to jelly, tea and compotes, it is mandatory to drink at least 2 liters of water without gas every day, and all products must be steamed or boiled. This will quickly normalize the stool and the functioning of the digestive tract, prevent constipation and relieve pain while visiting the toilet.

From the recovery diet after removal of hemorrhoids, the following products should be categorically excluded:

• vegetables: cabbage (in any form), legumes, cucumbers;
• fruits and berries: grapes, raspberries, currants;
• meat: game, pork, beef;
• cereals: barley, wheat, barley;
• dairy;
• dairy products with a high percentage of fat;
• drinks: alcoholic and highly carbonated drinks, coffee, hot chocolate.

Hygiene

It is very important to monitor the thorough hygiene of the anorectal area in the postoperative period. After a bowel movement, do not use toilet paper. The anus must be washed with warm water, gently drying it with a towel.

To prevent complications and accelerate tissue recovery in the first week after surgery, it is recommended to take sitz baths with infusion of chamomile, calendula or sage several times a day.

Physical activity

During the recovery period, patients who have undergone hemorrhoidectomy are strictly forbidden to lift weights and expose themselves to exhausting physical training. In the first time after the operation, walking, warming up the muscles after prolonged sitting in one position are useful. After the postoperative sutures have healed, it is recommended to perform a set of Kegel exercises or simple gymnastics to strengthen the muscles.

Possible Complications

Some complications can also affect how much hemorrhoids heal:

• painful bowel movements - in the first days after surgery, the pain can be very strong, and the act of defecation is painful. This is quite normal. Within 1-2 weeks, the pain will completely disappear. To alleviate the condition, patients are recommended to use antihemorrhoidal ointments or suppositories with anesthetics, which have an anti-inflammatory effect and accelerate tissue regeneration. It is also allowed to take laxatives;
• rectal bleeding - bleeding may begin to disturb the patient immediately after surgery or appear some time after it. Bleeding occurs due to trauma to the mucous tissue of the rectum or if the sutures are damaged by hard feces. In some cases, a poorly cauterized vessel during the operation becomes the cause of bleeding. Such complications are eliminated with the help of compresses with adrenaline or firmware of the damaged vessel;
• urinary retention is a complication that occurs in male patients during the first day after surgery. In this case, a catheter is used to remove urine;
• narrowing of the anal canal - occurs during surgery according to Milligan-Morgan. The reason is incorrectly placed seams. The narrowing is eliminated with the help of special dilators or plastics;
• suppuration, fistulas - develop due to the ingress of bacteria into postoperative sutures or into an open wound. Treatment is carried out with the help of antibacterial and anti-inflammatory drugs.

In the presence of the above complications, the rehabilitation period may take about two months. In the absence of complications and subject to the doctor's recommendations: diet, careful hygiene of the anorectal region, moderate physical activity, the body is completely restored within 1 month.

How many days and how long does hemorrhoids heal after surgery?

Hemorrhoidectomy helps a person get rid of an unpleasant ailment, however, the treatment does not end there. You also need to consider how long hemorrhoids heal after the removal operation, and what consequences may occur during the rehabilitation period. It is very important to strictly follow the recommendations of the doctor after the operation, otherwise hemorrhoids may appear again.

How long does hemorrhoids heal after surgery - the necessary conditions for recovery

Many are interested in how hemorrhoids heal. It is worth noting that in general the healing process is quite fast. However, the first weeks it is necessary to observe bed rest, since any movement can cause re-inflammation. Some patients feel well after a week, and therefore begin to move around a little. After 2-3 weeks, most people can already afford small walks several times a day, which is especially useful for overweight people.

In order for the healing process to go as quickly as possible, the following conditions must be observed:

• Norms of physical activity and behavior. In the postoperative period, it is important to abandon any physical activity, you can not lift anything heavy. In addition, you can not be nervous or scream. Any stressful situations can affect how many days the stitches will heal.
• special diet. Eat only light foods that are quickly digested and easily excreted from the body. The diet should contain more vegetables and fruits. It is forbidden to eat foods that lead to constipation. Food should be crushed, it is best to eat in small portions, up to 6 times a day. From the diet directly depends on how much time will be spent on rehabilitation. Constipation can cause a second attack of hemorrhoids, so you need to take nutrition very seriously during this period.
• Regular intake of medications prescribed by the doctor. Such medicines may include painkillers and disinfectants that will prevent the appearance of unpleasant symptoms and inflammatory processes in the tissues.
• Careful hygiene of the anus and genitals.

It depends on these points how many stitches heal after hemorrhoids. If the doctor's recommendations are not followed, hemorrhoids may reappear. In addition, the patient may experience other, more serious complications.

What complications can occur after the operation?

After surgery to remove hemorrhoids, there may be some complications. Moreover, they can appear both immediately after surgery, and later. Typical symptoms in the postoperative period are:

• Violation of urination. Basically, this symptom manifests itself in a man within a day after the operation. This is due to the use of epidural anesthesia. As a rule, during the first days, a catheter is used to remove urine. For 2-3 days, everything goes away on its own, additional treatment is not required.
• Painful sensations. There are a large number of nerve endings in the anal canal and in the rectum. After the action of the anesthetic ends, the patient begins to feel pain in this area. In this case, as a rule, the doctor prescribes special anesthetics that help get rid of painful symptoms.
• Prolapse of the rectum from the anus. This complication is extremely rare. It occurs only because of the incorrect actions of the surgeon, if the neuromuscular fibers were damaged during the operation. Elimination of complications is possible by both conservative and surgical methods.
• Bleeding. These symptoms may appear immediately after the operation, if during it the blood vessel was not sufficiently cauterized or stitched. As a result, due to the slightest movement, it can fall off and begin to bleed. In addition, the flow of blood from the vessels may appear as a result of hard feces or great effort during bowel movements. As a rule, bleeding most often occurs with constipation.
• Fistulas are also a very rare complication. Basically, fistulas appear when muscle tissue is captured during surgery. If there is a pathogenic microflora in the rectum, pus will soon come out through the fistulas. This inflammation is very serious, and therefore it is urgent to consult a doctor. Fistulas are removed surgically, extremely rarely by conservative methods.
• Narrowing of the anal passage. This complication occurs due to improper suturing. You can eliminate the pathology with the help of surgery or special dilators.
• Suppuration. Pus appears, as a rule, due to the fact that pathogenic microflora enters the postoperative sutures. In this case, to eliminate complications, it is necessary to use antibacterial and anti-inflammatory drugs. If the case is severe, sometimes they even open the wound and wash it.

Complications after removal of hemorrhoids can arise both as a result of a doctor's mistake during the operation, and as a result of the patient's incorrect behavior during the rehabilitation period. How long heals after removal of hemorrhoids, it is impossible to say for sure. In this case, it all depends on the individual characteristics of the body, as well as on compliance with the diet and hygiene rules.

What to do if hemorrhoids do not heal after surgery?

The healing of the tissues of the anus after surgery is a long process and often accompanied by inflammation. That is why many patients feel some difficulties during the rehabilitation period. In order for the healing to go as quickly and painlessly as possible, the patient is prescribed the following drugs and procedures:

• Nitroglycerin cream. This tool is intended for topical use, the cream must be smeared directly on the anal area. It helps to relieve pain and relieve spasm of the sphincter.
• Baths. You can use decoctions of chamomile or calendula for this procedure, as well as a weak solution of potassium permanganate. Such baths well disinfect the anus and skin, and useful substances contribute to the speedy healing of wounds and sutures.
• Rectal suppositories with anti-inflammatory effect. Natalsid suppositories are best suited in this case, they are often prescribed in the postoperative period.
• Methyluracil suppositories. This remedy contributes to the speedy scarring of wounds in the rectum or anus.
• Ice packs or cold packs. This remedy helps to temporarily relieve pain and reduce inflammation.

In general, the wound healing process after removal of hemorrhoids takes about a month. Throughout this period, it is extremely important to follow all the recommendations of the doctor. Bed rest is required for the first week. The second week is also best spent most of the time in bed, but with a positive result, it is already allowed to move a little. In the third week, as a rule, most patients feel a noticeable relief and gradually return to the process of life. After a month of rehabilitation, patients return to their usual way of life.

The period of rehabilitation after surgery to remove hemorrhoids: recommendations

Hemorrhoids is a common disease characterized by the appearance of unpleasant symptoms in the patient. Existing approaches to treatment are selected based on the patient's indications and contraindications. At the same time, surgical treatment allows you to cope with the disease, preventing its relapses.

general information

Hemorrhoids are accompanied by pathological expansion and tortuosity of venous vessels in the rectum.

This leads to the development of characteristic symptoms: pain with an increase in the level of intra-abdominal pressure (long stay in the toilet, constipation, weight lifting, etc.), spotting after defecation, etc.

The disease develops as a result of the presence in the patient of both hereditary factors (weakness of the connective tissue, mainly veins) and predisposing causes from the environment - a high level of physical activity, work associated with prolonged sitting, pregnancy, childbirth, etc.

All these reasons lead to an increase in intra-abdominal pressure and a pathological effect on the venous vessels.

Such a condition can lead to various complications, first of all, to thrombosis of the hemorrhoid, accompanied by intense pain and bleeding from the anus.

It is possible to prevent the progression of the disease with the help of drugs and surgical methods of treatment.

Surgical operations

The postoperative period after the completion of the operation to remove hemorrhoids depends on the type of operation performed. The following types of surgery can be performed on the patient:

1. Minimally invasive procedures performed on an outpatient basis allow you to immediately send the patient home. In this case, the recovery period lasts only 1-2 days.
2. Surgical treatment according to the Longo method, which consists in excising the mucous membrane of the rectum, also belongs to easily tolerated types of surgical interventions.
3. Ligation of venous vessels allows for the collapse of pathologically dilated veins.
4. Open and closed hemorrhoidectomy are performed to excise the altered veins. The radical nature of such an operation allows you to achieve a complete recovery and prevent the development of relapses in the future. However, the rehabilitation period after hemorrhoid removal by this surgical procedure lasts from 2 to 5 weeks, depending on the extent of the intervention.

The specific type of operation is chosen by the attending physician, depending on the diagnosed form of the disease, the available indications and contraindications.

Possible complications after surgery

Conducting surgery on the rectum can cause the development of certain complications that require the appointment of additional therapy. The most commonly reported negative effects are:

• Men may experience urinary retention after radical hemorrhectomy. Risks are increased with the use of epidural anesthesia;
• pain is the most common adverse effect. It is associated with abundant innervation of the rectum, soft tissues and skin around it. Treatment of this complication is based on the use of non-narcotic painkillers;
• much less often there is a prolapse of the rectum, which is associated with a violation of the function of the external sphincter of the organ. During the operation, the surgeon can damage the muscle fibers, which will lead to the development of such a complication;
• in addition, it is possible to develop bleeding from the rectum and pararectal soft tissues of varying degrees of intensity, the formation of fistulas and strictures in the lumen of the organ.

Timely detection of complications of surgical treatment allows you to prescribe additional therapy in time and get rid of unpleasant symptoms.

Organization of the recovery period

In order to accurately answer how long the recovery after hemorrhoid surgery takes, the attending physician must know the type of intervention performed, its volume, as well as the presence of concomitant diseases in the patient.

The rehabilitation period after this type of treatment should always include the following points:

1. Changing lifestyle and physical activity.
2. Selection of the optimal diet.
3. Rational use of drugs that improve recovery.
4. Compliance with hygiene rules.

On average, postoperative treatment of hemorrhoids and recovery is delayed for 4-6 weeks with open types of surgery, and 2-4 weeks with closed types of operations.

Lifestyle change

The recovery period after surgery for hemorrhoids necessarily includes the patient's compliance with several recommendations that change over time.

• the first two weeks after surgery, the patient must strictly observe bed rest. If this recommendation is not followed, the risk of developing a recurrence of the disease increases several tens of times;
• the first 6-9 days after surgery, the patient should be in a medical institution for the timely detection of possible complications of the treatment, as well as other undesirable reactions of the body. During this period, ointments against pain and microorganisms are actively used, as well as accelerating the healing of soft tissues (Methyluracil, Levomekol, etc.).

After two weeks of bed rest and discharge from the hospital, a second appointment is made with the attending physician, who evaluates the results of the operation.

• very often, patients ask questions, when can I sit down and start walking? As a rule, sitting on the bed is allowed for 2-4 days after treatment, but walking is best after 7-10 days;
• any intense physical activity, such as going to the gym, is allowed after 3 months if there are no contraindications;
• visiting baths, as well as saunas during the rehabilitation period is strictly prohibited;
• restoration of full working capacity falls on the 5th week of rehabilitation. It is during this period that a person can return to active work.

Diet

Proper nutrition is a key step in effective rehabilitation to avoid the development of constipation after removal of hemorrhoids, which can lead to relapse. The following rules apply to the diet:

• the diet should not contain complex foods - all food should be crushed and easily digestible;
• optimally break the daily meal into 5-6 stages;
• high content of vitamins and microelements in products;
• any products that can lead to constipation or flatulence should be excluded;
• do not eat salty, spicy, canned and smoked, due to possible irritation of the small and large intestines;
• The basis of the diet should be plant foods rich in fiber. This allows you to constantly stimulate the peristalsis of the colon and prevent the development of constipation;
• Patients are prohibited from alcohol and smoking.

It is desirable to maintain such changes in the diet for life, due to the therapeutic effect of compliance with these rules and the prevention of recurrence of the disease.

Medical support

Separately, it should be said about the use of additional methods of treatment to accelerate the healing of soft tissues. For this purpose, medicines and herbal medicine are used, in particular, various baths.

1. Painkillers after removal of hemorrhoids (Ketorolac, Nimesulide, etc.) can relieve pain and improve a person's well-being.
2. Methyluracil and other suppositories after hemorrhoid surgery accelerate the healing process and help relieve local inflammation.
3. Various herbal baths are actively used, primarily decoctions of chamomile, calendula and sage. Such baths have a complex therapeutic effect on damaged tissues. They effectively relieve inflammatory reactions, have antibacterial and analgesic effects.

Before using any medications and herbal medicine, you should consult your doctor about the appropriateness of their use and possible contraindications.

Hygiene

An equally important factor influencing how long hemorrhoids heal after surgery is the adequacy of a person's personal hygiene.

The patient needs to wash himself after the act of defecation, and not use toilet paper.

For this purpose, a shower or a special bidet is best suited.

If the need to visit the toilet arose at a party where there is no way to wash yourself, then it is optimal to use wet wipes, which you should always carry with you.

Conclusion

The period of postoperative rehabilitation is extremely important for restoring the patient's quality of life and preventing recurrence of the disease. Information about the necessary measures can be obtained from your doctor or from special brochures for patients.

What to do after the operation to remove hemorrhoids, when can I sit and how is the treatment in the postoperative period?

Operations to remove hemorrhoids have long been part of the practice of modern surgery.

However, not all citizens who decide on such an intervention are aware of how the postoperative period goes, what are its nuances and features.

We will deal with what you may encounter after you have coped with this ailment, what should be the postoperative treatment of hemorrhoids and how to go to the toilet after hemorrhoid surgery.

Postoperative period

The postoperative period, which occurs immediately after you have undergone surgery to remove hemorrhoids, is characterized by discomfort and unusual pain. These are typical companions that accompany patients after each surgical intervention, so you should not be afraid of them.

However, already on the third or even fourth day after the removal of hemorrhoids, the patient begins to feel much better.

If you follow all the doctor's advice on treatment after removal of hemorrhoids, conserve strength, stick to a diet and follow other instructions, then you can return to normal life within a week after you lay down on the surgical table.

However, do not think that this will remove all restrictions on diet and exercise.

First of all, you will have to observe bed rest for at least the first two weeks. This is due to the fact that an even more pronounced recurrence of hemorrhoids can occur from an excessive load on the body, thereby prompting your body to succumb to a new, even more terrible disease.

Secondly, do not forget that light physical activity is good for your body. Even lying in bed, you can do the simplest exercises after hemorrhoid surgery, which involve raising your arms or legs.

Do not be zealous, but weekly increase the load. Also, it can positively affect those patients who are overweight. The absence of extra pounds as a result of exercise reduces the risk of recurrence of hemorrhoids.

Diet

In the postoperative period after removal of hemorrhoids, special attention should be paid to the diet. A well-chosen diet can help you recover faster or, conversely, aggravate the situation.

That is why, your daily diet for hemorrhoid surgery in the postoperative period should include the following foods:

In addition, do not forget that many useful substances are found in various cereals and legumes.

Do not deny yourself beans, lentils, rice, buckwheat. They are rich in vitamin B, contain high levels of iron, which is useful for reducing pressure on hemorrhoids.

Another important rule of the recovery diet is the consumption of plenty of fluids. Remember that only water is recognized as a liquid, and not drinks in the form of compote, tea, and so on.

In order for the defecation procedure not to be painful for you, it is necessary to consume more than two and a half liters of water per adult per day.

Such a measure helps you deal with problems of the digestive tract and the resulting constipation, which is a frequent companion after hemorrhoid surgery.

However, remember that many dishes from your diet should be excluded, as they contribute not only to the occurrence of a recurrence of hemorrhoids, but can also become a source of new diseases of an organism that is still fragile after surgical intervention.

While you may have enjoyed eating meat and seafood before your hemorrhoid surgery, there are certain foods that you should be wary of now.

Foods that can cause hemorrhoids:

However, this does not mean that you can eat only all kinds of vegetables and fruits. Among them, too, lies a danger. So, eat with caution:

• raw cucumbers,
• pepper,
• boiled cabbage,
• radish,
• as well as other vegetables that have a fibrous structure.

Your postoperative diet should be free of condiments in the form of mustard, pepper, sauces, ketchup, and other hot spices.

Deny yourself the pleasure of eating olives, marinades, herring, caviar, sauerkraut and pickles.

Sweet confectionery in the first months after the operation to remove hemorrhoids is also prohibited. However, you can indulge yourself with delicious and herbal teas, fruit smoothies, and even baked goods, where fruit is predominantly present.

We explained the diet, but when you can sit down after removing hemorrhoids - we will tell further.

When can I sit after hemorrhoid surgery, physical activity

Despite the fact that this operation is complicated, doctors insist on physical activity a day after it was performed. When can I sit down after hemorrhoid surgery?

So, on the second day you will be asked to sit down on a chair. To begin with, you need to sit on several pillows, gradually removing one by one daily.

When performing a squat, you should not experience sharp pain, but unpleasant sipping is a frequent companion after an operation to remove hemorrhoids.

Also, doctors ask their patients to adhere to the principle that it is better to lie down or walk than to stand or sit.

Eliminate physical labor for one month after surgery, be wary of sports and activities that involve lifting weights of more than a kg.

But if you decide to go in for swimming, easy running, then doctors recommend that you start such activities already in the third week of rehabilitation therapy.

Refrain from sexual intercourse for the first two weeks. But frequent long walks in the fresh air at a moderate pace are the best way to recover. The main thing is to try not to freeze, since the body that has recently undergone surgery is susceptible to various colds.

Since in the postoperative period you cannot allow stress on the anus for a long time, you need a special anatomical shape of the pillow in order to sit comfortably in a chair, while not exposing your body to stress.

Pillows after hemorrhoid surgery may differ in their shape, composition and other parameters. You can choose the one that you think is the most convenient.

Doctors may advise you to purchase such a pillow, but it is not a complete way to get rid of pain after hemorrhoid surgery and is not required.

We figured out when you can sit after hemorrhoid surgery, now consider the question of what to do with hemorrhoids after surgery for its complete healing.

And also with minimally invasive manipulations:

How long can the healing process take?

How long does the damaged area heal after hemorrhoid surgery? Recovery and treatment of hemorrhoids after an operation called hemorrhoidectomy lasts for one month if a closed operation was performed, and about two months if an open form was chosen.

If the patient has complications, then the treatment process after hemorrhoid surgery can drag on indefinitely. However, if you feel that the healing process is going a little faster than it should, do not neglect the advice of your doctor, but strictly follow them so that there is no recurrence of hemorrhoids in the future.

How to treat hemorrhoids after surgery? To do this, the doctor may advise you to take sitz baths based on herbal decoctions, which have a beneficial effect on diseases such as hemorrhoids. These include sage, chamomile, calendula, and some other plants. Such procedures after hemorrhoid surgery bring many benefits.

Often, doctors advise using various ointments that contribute to the effective scarring of tissues.

What are the possible complications and how to deal with them?

The operation to remove hemorrhoids and the postoperative period are rightfully considered difficult and it is likely that the patient may experience complications.

This may be due both to an incorrect rehabilitation procedure after removal of hemorrhoids, and, in principle, to the body's refusal to interfere in its work.

Therefore, after you have been discharged from the hospital, you need to carefully listen to your well-being, monitor discharge after hemorrhoid surgery and other symptoms that may initially indicate the presence of serious complications after hemorrhoid removal.

The main signs that indicate the presence of complications after hemorrhoid surgery are the following factors:

1. Firstly, it is the pain that you will experience with each bowel movement. The presence of pain up to two weeks is considered the norm, but longer than this period is a sign of the presence of complications that require immediate examination by a specialist.
2. Another sign that should not leave you indifferent is an increase in temperature after an operation to remove hemorrhoids above 37.5 °.

Since the procedure for removing hemorrhoids is an operation, it is possible that the number of white blood cells in your blood will be exceeded, which will cause a slight increase in temperature after the removal of hemorrhoids.

However, the norm is an increase in body temperature up to 37 degrees. If, in addition to the temperature after surgery for hemorrhoids, you feel chills, severe fatigue, periodic malaise and dizziness, this is a sign of an inflammatory process in the body.

It is worth paying special attention to the presence of consequences after the removal of hemorrhoids by surgery, and any of your delay can cause a recurrence of hemorrhoids.

Hemorrhoids after surgery - photo:

Ways to normalize stool

How to go to the toilet after hemorrhoid surgery? It is possible that during the recovery period after the operation to remove hemorrhoids, you will have problems with going to the toilet.

This is due both to the presence of pain after hemorrhoid surgery, which is brought by tissues that have not yet healed, and to the process of defecation itself.

Most often, patients experience constipation after hemorrhoid surgery. In this case, you need to adhere to a certain technique so as not to cause yourself more harm.

How to treat the anus after hemorrhoid surgery? Ask your doctor to prescribe pills or suppositories after hemorrhoid surgery to help you manage pain after hemorrhoid removal. Ibuprofen, or other painkillers can be prescribed: suppositories with papaverine, Anestezol, suppositories with belladonna, fast-acting ointments.

What to do with constipation after hemorrhoid surgery? When visiting the restroom, do not try to push all the contents out of yourself. Be extremely careful, and if after two minutes of going to the toilet you are unable to complete the bowel movement, then try to do it again after half an hour.

If there is no stool after hemorrhoid surgery, in between visits to the restroom, you need to drink as much water as possible, as well as eat foods that help thin the stool.

You can also use various microenemas against constipation after hemorrhoid surgery, which will help you empty your intestines without harm to your health. However, you can use them only after the attending physician allows it. Read more about microclyster Microlax here.

Also, during the rehabilitation period after surgical removal of hemorrhoids, a problem such as incontinence is often encountered. Be prepared for the fact that, perhaps, it will manifest itself in you.

In order to avoid embarrassment because of this, the consequences of hemorrhoid surgery and to reduce the effect of surprise, stock up on special diapers for adults in advance. If the healing process goes as planned, in the near future you will be able to refuse them.

Your doctor should prescribe you drugs that will help harden the stool and normalize the stool after hemorrhoid surgery.

Therefore, if you experience discomfort in the presence of such an ailment, be aware that this is not for long, and is a rehabilitation procedure after hemorrhoid surgery. Train your nerve endings and muscles with a little gymnastics, which is possible within the limits of what is permitted.

Conclusion

Continue to adhere to a diet, albeit not strict, but still, walk more, breathe fresh air, pay attention to physical activity, be careful in your movements.

When can I sit after hemorrhoid removal?

Modern medicine offers to solve the problem of hemorrhoids with the help of therapeutic diets, pharmacological agents, folk recipes, homeopathic medicines, gymnastics and breathing exercises, and surgery. Patients do not want to resort to the latter type, fearing pain, discomfort, and health risks. But only surgical procedures can:

solve the problem promptly. Immediately after the operation, there is no more expansion of the hemorrhoidal veins. Pharmacological preparations, physical education require months for this;

• give instant results. In the later stages of the disease, nothing but surgery can restore the functionality of the anus. Self-medication delays time, leads to complications. At stages 3-4 of hemorrhoids, sitz baths, enemas, compresses, rectal suppositories will temporarily relieve discomfort in the anus, but will not solve the problem. Therefore, it is necessary to contact a proctologist and choose the type of surgical intervention;
• stop the bleeding. With infringement of the nodes, anal fissures often bleed. Patients ask the question, when can surgery be done in this condition? It all depends on the condition of the patient and the localization of the node. In any case, the surgeon will quickly stop the blood and normalize the activity of the sphincter;
• performed under local anesthesia. Modern types of surgical intervention last several minutes and do not require the patient to be “turned off”. After hemorrhoid surgery, you can leave the hospital. And after a couple of days, lead a normal life.

After the first few weeks of the postoperative period after removal of hemorrhoids, light but consistent physical exercises can be started.

You can sit after surgery immediately or after a couple of weeks. The question is individual, and your doctor can answer it. It all depends on the type of surgery, the quality of the recovery process and adherence to the recommendations of the proctologist.

Operation types

To correct hemorrhoids, low-traumatic methods and classical techniques are used. It all depends on the condition of the patient, the stage of the disease, the type of nodes.

Minimally invasive procedures do not require a long recovery process, have no contraindications, and are quickly performed under local anesthesia.

• cryotherapy. A special device affects the expansion and inflammation of the vein of the anus with liquid nitrogen at a temperature of -196 ° C. The operation lasts 10 minutes, recommended for the first stage of hemorrhoids;

If the state is running, resort to classical techniques:

• Longo hemorrhoidectomy. Remove not only the node, but also the affected part of the mucous membrane. With large volumes, a neglected state, plastic is needed;
• hemorrhoidectomy according to Milligan-Morgan. Work only with hemorrhoids;

• according to Sklifasovsky. The expansion of the vein is tied with a surgical thread. Without blood supply, the node quickly necrotic, dies.

Before surgery, the patient receives treatment - the so-called minimally invasive procedures

Recovery after surgery

How to recover after surgery? How long and difficult is it? Such questions are often asked by patients to proctologists. Patients do not know the intricacies and nuances of rehabilitation therapy. Therefore, some points will be interesting:

• There is discomfort after surgery. This is inevitable, because the integrity of the mucous membrane was violated. Sensations with correctly performed manipulation disappear in 3-4 days. Then you can sit after surgery for hemorrhoids;
• It is possible to minimize discomfort with the help of ice compresses or special pillows. Devices against hemorrhoids are donut-shaped. They distribute the weight evenly, relieve the load from the spine, normalize blood circulation;
• you can start your usual active lifestyle, classes in the gym after 6 weeks. The first 14 days minimize movements; after classical operations, this recovery period is spent in bed;
• painkillers are selected by the proctologist. They relieve discomfort during bowel movements or long sitting. It is dangerous to prescribe such medicines for yourself, allergies and complications may develop;

Diet

Recovery is impossible without proper nutrition. The patient after the operation monitors the chair, does not allow constipation and diarrhea. Its menu includes:

• vegetables and fruits. Fresh, steamed, baked, boiled, they are a source of vitamins, antioxidants. Substances are necessary to maintain local intestinal immunity at a high level, to prevent the purulent-inflammatory process;
• cellulose. Vegetables are introduced into the menu or dietary supplements are used. Vegetable fibers play the role of intestinal filler. They dilute the feces, make them more voluminous;

• legumes. Some patients avoid foods due to the risk of flatulence. After heat treatment, peas, lentils, soybeans are easily digested, serve as a source of essential amino acids, and contribute to the normalization of stool;
• water. Compliance with the water-salt balance is an important part of rehabilitation therapy. The liquid prevents the stagnation of feces, the formation of blood clots and stagnation of blood in the pelvic organs. To normalize water-salt metabolism, drink at least 1.5 liters per day;
• refusal of marinades, pickles, smoked meats, fatty meats, seafood.

Substances rich in extractives irritate and stimulate the alimentary canal. If at normal times this is permissible, then after surgery it is worth refusing to additionally stimulate the secretion of gastric and intestinal juice. For this reason, they reduce the rate of strong coffee or tea, replacing the liquid with compote;

• hot spices, ketchup, chili, wasabi, mustard banned;
• avoid foods with a spicy taste and aroma: sauerkraut, herring, olives, pickled and pickled cucumbers, game;
• rejection of bone berries: currants, raspberries, cranberries. Mechanical particles are not digested and injure the operated intestine during defecation.

Complications after surgery

In some cases, recovery after surgery may not go according to plan. Everything is individual.

Depending on the age of the patient, the stage of the disease, the method of surgical intervention, compliance with the recommendations of the proctologist, complications occur immediately or after 2-3 months.

The most common problems:

• fistulas. The operated site has a connection with the external environment. A connective tissue opening connects the outer skin and the inner lining of the anus. It is dangerous that pus accumulates in the cavities of the fistulas, the inflammatory process of the subcutaneous tissue begins. The condition is corrected with the help of surgery or pharmacological means;
• constriction of the sphincter. Poor quality suturing causes a violation of the anatomical structure of the anus. It is decreasing in size. This provokes discomfort and pain during bowel movements. The condition is especially deplorable during constipation. Correct with the help of plastics;

Bleeding. It may open immediately after the completion of the operation or a few days later, the cause is the appearance of cracks or damage to the mucous membrane by hard feces

• bleeding. There are due to trauma during surgery or insufficient treatment of blood vessels. In a hospital setting, the condition is stabilized with the help of pharmacological agents or coagulation. There are recipes based on medicinal herbs that help stop the bleeding. But their independent use can provoke complications. Therefore, the solution of the problem should be entrusted to an experienced proctologist;
• acute urinary retention is rare in men. The problem is solved by the use of antispasmodics. If ineffective, catheterization is performed;
• rectal prolapse is the most dangerous complication. The condition requires immediate surgical intervention. Without it, infringement of the rectum, necrosis, infection of the mucosa begins, sepsis develops rapidly.

Recommendations for recovery after surgical removal of hemorrhoids

Resection of hemorrhoids does not yet make it possible to assume that everything is over. The implementation of the recommendations of the proctologist in the postoperative period after the removal of hemorrhoids is an important therapeutic stage, and the prognosis of treatment and the likelihood of complications depend on how the work of the rectum and anus is restored. To recover from the disease, you need to familiarize yourself with the basic principles of postoperative rehabilitation.

The duration of the postoperative period

The length of recovery time after hemorrhoid surgery depends on a number of factors:

• methods of surgical intervention;
• type of hemorrhoidal lesion (internal, external or combined);
• age;
• existing intestinal diseases;
• work of the immune system (chronic diseases slow down postoperative treatment and increase the risk of complications).

How long does postoperative recovery take? On average, rehabilitation after removal of hemorrhoids lasts from 2 weeks to one and a half months, and the further prognosis of the disease depends on how much the patient follows medical recommendations at this time.

The main rules of rehabilitation

The recovery technique in the postoperative period is selected individually for each patient and is aimed at restoring the full functioning of the vessels. Treatment after hemorrhoidectomy should be comprehensive and includes the following:

• The use of medicines. To accelerate the healing of postoperative sutures, ointments or suppositories are applied topically after surgery with analgesic, wound healing, anti-inflammatory or hemostatic effects (drugs are selected taking into account the patient's problem after resection of hemorrhoidal cones). With a successful operation, treatment with medications may not be required.
• Diet food. While scars are healing after excision of hemorrhoids, it is necessary to minimize the risk of injury to the rectal or anus mucosa with intestinal gases and dense feces. Food during the recovery period should be easily absorbed by the body and not linger in the intestines.
• Hygiene. It is necessary to wash the anus with cool water using baby soap. Non-compliance with hygiene in the postoperative period after removal of hemorrhoids often causes infection of the sutures with pathogenic microflora.
• Adequate physical activity. Despite the fact that, approximately 4 days after hemorrhoid surgery, many patients feel much better compared to the preoperative state, scar healing has not yet occurred and it is necessary to minimize the physical load on the pelvic area to prevent possible complications.

In order for the recovery after removal of hemorrhoids to pass without complications, you must follow all the points of medical recommendations. Failure to follow the rules of rehabilitation can cause the reappearance of hemorrhoidal bumps or the development of other problems in the patient.

Patient problems in the early rehabilitation period

Surgical removal of hemorrhoids does not always immediately relieve the patient of problems; early postoperative complications often occur. Most often, patients experience the following discomfort:

• Pronounced pain syndrome. After the action of anesthesia ends, patients have pain in the anus. Sometimes the pain is so unbearable that injections of non-narcotic (Nimesulide, Diclofenac) or narcotic (Promedol, Omnopon) analgesics are prescribed to alleviate a person's condition. Usually, severe pain lasts no more than 2-3 days and gradually subsides as postoperative scars heal.
• Urinary retention. Temporary difficulty urinating occurs more often in men after hemorrhoid surgery, when epidural anesthesia was used. This disorder is temporary and rarely requires treatment, usually normal urination is restored on its own within a day after the removal of hemorrhoidal formations. In order to alleviate the condition, patients are shown catheterization of the bladder.
• Prolapse of the rectum. Such consequences after removal of hemorrhoids in patients do not happen often and usually appear when the anal sphincter was affected during the operation or the person has valve weakness. To eliminate the violation, depending on the severity of the condition, conservative or surgical treatment is used.
• Narrowing of the anus. This happens if the hemorrhoidectomy was done with improper suturing. In patients, the consequences of improper suturing of surgical wounds will be pain during defecation and a constant feeling of incomplete bowel movement.

An operation to remove hemorrhoids, in addition to pain in the operated area, may not cause any negative consequences, but a number of patients experience psychological problems associated with the act of defecation. A person is afraid of stool retention and at the same time is afraid of going to the toilet. To eliminate the problem that has arisen, laxatives are prescribed and, for pain, mild analgesics. In severe cases, patients need the help of a psychologist to deal with fear.

A psychological problem with bowel movements, if not treated in a timely manner, will eventually lead to constipation and trauma to the anus.

Fundamentals of clinical nutrition

Full recovery after surgery directly depends on what a person eats. Nutrition during the recovery period must comply with the following rules:

• Balance. Despite the exceptions from the diet of a number of products, the body must receive the necessary vitamins and nutrients.
• Fractionality. It is recommended to eat in small portions, but often (up to 5-6 times a day).
• Cooking method. To reduce the risk of intestinal disorders, it is not recommended to fry food; it is advisable to cook dishes by stewing, baking or boiling.
• Method of eating. Each piece should be thoroughly chewed before swallowing and avoid drinking various drinks while eating.

The suggested tips will help reduce the risk of constipation and flatulence, which during the rehabilitation period can cause pain and discomfort to the patient.

In addition to the rules for eating, attention should also be paid to the food set, because the full work of the intestines depends on the type of food eaten.

Healthy food

The menu of the postoperative period should include foods rich in fiber and moisture.

• porridge (except rice and semolina);
• vegetable soups;
• vegetable puree;
• omelets;
• meat or cottage cheese casseroles;
• low-fat dairy products;
• fruits and berries without seeds;
• compotes and juices;
• ground or finely chopped meat and fish of low-fat varieties.

Prohibited Products

Rehabilitation after surgery requires the maximum reduction of the load on the intestines. From the menu you need to remove:

• fresh milk;
• fatty fish and meat broths;
• seasonings;
• sauces;
• mayonnaise;
• vegetables with coarse fiber (onions, radishes, spinach, etc.);
• fatty fish and meat;
• sweet fresh pastries;
• any products with cocoa;
• fruits and berries containing small seeds (raspberries, kiwi);
• strong coffee and tea;
• alcoholic drinks;
• carbonated waters.

After the operation is performed, patients are not recommended to eat food during the first day, and after that they need to eat in compliance with the above rules.

It seems difficult for many patients to limit themselves to food, and very often doctors hear the question: “After resection of hemorrhoids, how long should you diet?”. At least as much as scars heal after surgery (on average, this happens within a month).

Those who are looking forward to the end of the diet in order to have a tasty meal should think about the possible consequences: if you eat too much heavy and spicy food, hemorrhoids after surgery may reappear. Proctologists recommend that patients, even after the end of the rehabilitation stage, adhere to a milder version of the proposed diet and eat harmful foods in small quantities.

Physical activity after surgery

The treatment of hemorrhoids does not end with the operation, after the removal of hemorrhoidal cones, in order to ensure the full restoration of the body's work, it is necessary to provide a gentle load on the perineum during the rehabilitation period. Depending on how much time has passed since the hemorrhoidectomy, doctors may recommend the following:

• In the first days, complete rest. Patients must observe strict bed rest, while it is strictly forbidden to strain the press and make sudden movements. During this period, tissues damaged by surgery actively heal and scars form.
• Physical exercises can be done only for 2-3 weeks. Proctologists recommend walking in place or breathing exercises. Physical activity, which does not cause overstrain of the muscles of the perineum, improves the blood supply to the tissues, and the healing of scars takes less time.

Sexual contact is allowed only 2-3 weeks after hemorrhoidectomy, while anal sexual contact is strictly prohibited.

Postoperative recovery lasts up to 2 months and all this time the patients are considered disabled.

To reduce the risk of re-formation of hemorrhoids, it is recommended not to sit for a long time. Doctors advise people whose work activity is associated with long sitting at a table or driving to purchase a special ring pillow for the seat.

• Wear soft underwear. It is unacceptable to wear shorts made of coarse synthetic fabrics. And women are not allowed to wear thongs.
• Wash the perineum with water and baby soap 2 times a day.
• Use only soft toilet paper (if possible, it is recommended to wash with cool water after each bowel movement).

Possible postoperative complications

Removal of hemorrhoids can be successful, but due to the violation of the rules of rehabilitation by patients, sometimes complications arise:

• The appearance of suppuration. The most common problem with non-compliance with hygiene rules. If you do not start treating the formed abscesses in a timely manner, then in the future this will lead to phlegmon or to the formation of a rectal fistula.
• The appearance of bleeding. Such a complication becomes a consequence of injury to areas of the anus and rectum that have not yet healed with feces or with strong tension in the muscles of the perineum. Bleeding can be slight or profuse (if large vessels are damaged). For treatment, hemostatic sponges are used and, if necessary, injections of hemostatic agents are made.

These phenomena in most cases can be avoided by following medical recommendations.

Signs of complications

It is possible to suspect deviations in postoperative healing by the following signs:

• Prolonged severe pain. The normal duration of severe pain should not exceed 2-3 days; in most operated patients, the pain becomes moderately tolerable already a day after the operation.
• Fever. On the first day, a slight subfebrile rise in temperature is possible, but if hyperthermia lasts for several days, then this is a sign of an inflammatory process.
• The appearance of purulent discharge from the anus (occurs with feces during bowel movements).
• The appearance of blood stains on linen. A small amount of blood in the stool is acceptable, but if bleeding is profuse and is noted not only during a trip to the toilet, but also at rest, then this is a dangerous sign.

The consequences of the operated hemorrhoids are always dangerous and require immediate treatment. If you ignore the symptoms that have arisen, then life-threatening conditions may develop in the future.

The surgeon can perform an operation and remove hemorrhoidal bumps, but further recovery depends not only on the doctor, but also on the patient. If the patient strictly follows medical recommendations regarding nutrition, hygiene and physical activity during rehabilitation, then the prognosis is favorable. During the healing period of postoperative scars, the risk of complications is minimal and there is almost no recurrence of the disease.

Surgical intervention for herniated discs is prescribed quite rarely, and such a conclusion indicates a special degree of severity of the pathology. The success rate of the operation is quite high, but not guaranteed. It is important to understand that in addition to the operation itself, there is also rehabilitation after the removal of an intervertebral hernia, neglecting which will nullify all the efforts of surgeons.

Any rehabilitation after removal of a herniated disc helps a person gradually adapt his body to a lifestyle in which there will be no recurrence of the pathology. Remember that the postoperative recovery period is purely individual and you need to be able to analyze your condition, listen to the advice of doctors and take your time.

The main feature is the individual duration for each patient, which is determined by the type of operation (with rough methods with fusion of the vertebrae - up to a year), the age category of the patient and the size of the intervertebral hernia. In the period that comes after the removal of the intervertebral hernia, it is important to ensure that the patient is looked after by such specialists:

• The doctor who treated the patient before the operation;
• The doctor who performed the operation;
• A doctor who specializes in postoperative rehabilitation.

The main goals that proper recovery after surgery helps to achieve:

• Formation of the correct muscular corset and posture;
• Restructuring lifestyle for a new height of the spinal column (reduction due to disc removal during discectomy);
• Elimination of pain and return to normal functioning.

Stages of rehabilitation

Early period

The first 14-15 days after the removal of a spinal hernia is an early recovery period, which implies many limitations. The course of drug treatment is also ongoing. The patient is prescribed various drugs that relieve inflammation and pain. Another necessary measure is constant examinations, sometimes even an MRI. It is important to ascertain the effectiveness of the operation and its effect on the soft tissues of the back. You will also need to pass a number of other tests at the discretion of the doctor.

Some people do not feel like getting out of bed during this period, but doctors recommend movement. Of course, not immediately, but a few days after the operation to remove the intervertebral hernia.

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The first safety measure in case of walking will be a rigid orthopedic corset, which has a lot of useful qualities:

• The required degree of rigidity will not allow you to make sharp turns with the body;
• By reducing the load with such a device, the patient feels less pain when walking.

Walking 3 days after surgery is useful, but there are some limitations:

• Duration - should not exceed 90 minutes;
• You can’t sit down; when getting up, this position should be avoided;
• Walk only in an orthopedic corset, putting it on lying down.

Late period

When the patient stops complaining about pain, the so-called “late rehabilitation period” begins, which lasts up to 8 weeks. During this time period, the patient must restore the mobility of the "squeezed" areas of the back, finally get rid of pain and strengthen the muscle corset.

Exercises

In the late period after the removal of the intervertebral hernia, some physical exercises and physiotherapy procedures are recommended. Any exercises after removal of the intervertebral hernia must be performed without sudden movements, all techniques must be discussed with your doctor.

After spinal surgery, it is necessary to start with a very short duration of training. The simplest movements are selected that contribute to the normalization of blood circulation.

The following gymnastic exercises are usually used:

• Light bending of the back (rounding) with knees bent at the legs;
• Movement with straight arms with a flat back;
• Kneading movements with arms bent at the elbows.

Any physical education is performed only if there is no pain. And if there is, either you need to wait, or consult a doctor about other exercises.

Physiotherapy

• Novocaine electrophoresis - serves as an excellent pain reliever;
• Ultrasonic irradiation;
• Impact with magnetic fields;
• Exposure to weak electric current;
• The use of mud solutions to reduce pain and relieve swelling.

Delayed period

The use of exercise therapy after removal of the intervertebral hernia is not limited to the late period. The delayed period begins from 3 months of rehabilitation, but even at this time the patient is not yet strong enough and one should be extremely careful when performing one or another exercise. You should not make sudden movements and exercise for too long, smoothness in movements and proper technique are important. Failure to follow these rules can cause pain. In this case, you should stop exercising or reduce their intensity. When pain accompanies any exercise, this is an occasion to visit a rehabilitation doctor.

A good choice would be push-ups from the floor and semi-squats. Such exercises can well strengthen the muscular corset with minimal stress on the spine.

Morning exercises will also become a constant companion in life for people who have undergone such operations. Proper therapeutic exercises are very useful for the back after removal of a vertebral hernia and at any other time, exercises restore impaired blood circulation, relieve spasms.

Exercises on simulators

The rehabilitation doctor also prescribes an individual course of kinesitherapy, which perfectly relieves pain. Any exercise is performed with the help of simulators. The main goal is to smoothly stretch the spine with an increase in the space between the vertebrae. Orthopedic trainers involve fairly long sessions to reduce the risk of pinched nerve endings. Slow stretching of the spine relieves inflammation and pain.

Also, after surgery for a hernia of the spine, a set of stretching exercises is used. It is very effective to use them underwater. For this, various weights and devices are used.

Baths

Everyone knows that the density of water is higher than the density of air. Accordingly, the spine in such an environment will be much less loaded and the person will be able to relax faster. But in order to enhance the relaxing effect and add anti-inflammatory to it, it is necessary to add various substances to the baths. Here are some examples:

• hydrosulfide baths. Able to significantly reduce swelling, improve blood circulation, relieve spasms.
• With the addition of turpentine ointments. Substances actively affect the focus of inflammation and help accelerated wound healing after surgery.
• Baths with medicinal herbs. They serve as an excellent sedative, help get rid of inflammation and relieve stiffness from the muscles.
• Baths with dissolved inert gases. One of these substances is Radon, which has an anti-inflammatory effect.

Sanatorium treatment

After a few months, when the time for active rehabilitation passes and the body gets a little stronger, you can think about a trip to a sanatorium. Everyone knows that in such institutions the body is perfectly restored.

If you try to be treated at home, the effect will be, but not so strong. You will need considerable perseverance to regularly perform all the exercises and attend the procedures.

In the case of a sanatorium, it is easier to restore your health, because there are many doctors - rehabilitators who will prescribe the necessary procedures and monitor your condition. Such institutions provide many specially equipped rooms where various wellness procedures are carried out. The patient is selected a number of procedures that depend on his condition:

• Various kinds of therapeutic baths;
• Mud compresses;
• Sunbathing;
• Paraffin therapy;

We must not forget about the enormous benefits of the sea climate, which greatly speeds up recovery. Another plus of the sanatorium is proper nutrition. Doctors know what substances the patient needs for recovery - with a high content of fiber. It is in sanatoriums that the diet is easiest to observe.

Contraindications for rehabilitation

Surgical intervention in the structure of the spine is a dangerous thing that can have many unpleasant consequences. Even if everything went well, your spine will no longer be the same and it is important to remember this in order to avoid relapses of the pathology. There are many rules that must be observed in order not to nullify all the efforts of surgeons.

Treatment of hemorrhoids does not end with the removal of hemorrhoids - after the operation, the patient will have to go through a rehabilitation period. It is especially important to follow the doctor's recommendations in the early postoperative period. What are the rules andwhat to do after hemorrhoid surgeryconsider in this article.

For two weeks after the operation, the patient needs bed rest. It should be remembered that with any excessive effort, a recurrence of hemorrhoids can begin.

Early postoperative period after hemorrhoidsincludes the following activities:

• Careful observance of hygiene rules. Compliance with this rule will avoid the development of inflammation of the postoperative suture. Hygienic procedures are carried out using chamomile infusion and a weak solution of potassium permanganate. After each visit to the toilet, be sure to wash with warm water.
• Candles. In order to prevent the occurrence of an inflammatory process, patients are prescribed Nitalsid suppositories, which help relieve inflammation and stop hemorrhoidal bleeding. This drug can be used both before and after surgery.
• Ointments. Rehabilitation after surgical removal of hemorrhoidsincludes activities that promote healing and scarring of wounds. To do this, apply wound healing ointments for external use, as well as suppositories containing methyluracil.
• Painkillers.The next day after surgery, the first stool appears in patients, which is accompanied by severe pain. They are removed with painkillers, non-narcotic analgesics, non-steroidal anti-inflammatory drugs. Also, patients are prescribed drugs to eliminate edema. To prevent the occurrence of constipation, patients are advised to take laxatives. Microlax is considered the most effective and common among them.
• Cold compresses. If the patient is concerned about pain, then ice packs can be used to relieve them. Such compresses are applied to the painful area daily for several days in a row.
• Plentiful drink. To avoid constipation, patients need to drink plenty of fluids, as it helps soften the stool.

In the absence of any serious complications, you can limit yourself to simple home measures. Homerehabilitation after hemorrhoidsincludes compliance with hygiene rules and the use of traditional medicine. However, it should be noted that the use of medicinal herbs is possible only with the consent of the attending physician. Chamomile and yarrow are usually used as medicinal herbs - they are used to prepare sitz baths or decoctions for internal use.

late recovery period

A few weeks after the operation, the patient is allowed light but consistent physical activity. The most effective and safe among them is walking for 5-10 minutes 2-3 times a day.

At a later stageFor a quick return of patients to a normal lifestyle, the following recommendations should be observed:

• Cleaning the anus after each visit to the toilet. For this purpose, a medical ointment prescribed by the attending physician should be used.
• Taking sitz baths. The temperature of the medicinal decoction should be comfortable for the patient, and in no case hot. The bath should be taken for 10-15 minutes. Regularly carrying out such procedures will reduce inflammation and eliminate unpleasant odors.
• Reception of anesthetic tablets - is carried out only if necessary.
• Hemostatic injections - prescribed to the patient when bleeding occurs in anal fissures.

When can I sit down after the operation?

when can i sit after hemorrhoid surgery? Some patients can sit up the very next day after surgery, while others may take several weeks to do so. In this case, it all depends on the following factors:

• Type of surgical intervention. As a rule, when using a low-traumatic method, the patient will be able to be in a sitting position immediately after the treatment procedure.
• The quality of the recovery process. If all the recommendations of the proctologist are followed, recovery occurs faster, respectively, the patient will be able to take a sitting position sooner.

To alleviate the condition and reduce pain while sitting, patients are advised to use a special anti-hemorrhoid pillow. This orthopedic device contributes to a significant increase in the effectiveness of therapeutic methods. It can be used both in the postoperative period and with hemorrhoids in the acute stage.

In the center of the special pillow there is a recess or notch, which contributes to the transfer of the main load when sitting on the femur and pelvic bones. As a result of reducing the load on postoperative sutures and rectal veins, the anus does not come into contact with the surface of the stool. This prevents leakage, pinching of hemorrhoids and tissues injured by the operation.

Food

Recovery after hemorrhoid removalhappens much faster with the right diet. Patients should know which products are preferable to use in the postoperative period, and which are better to refuse.

Healthy foods

Convalescent patients are shown foods containing beta-carotene, vitamin C and other antioxidants, as they are great for supporting immune function. These foods contain fiber and fluid that help soften stools and reduce the risk of punctures in the seams from coarse and dry foods.

AT postoperative period after removal of hemorrhoidsit is recommended to consume as many vegetables rich in fiber as possible - carrots, cabbage, tomatoes, cucumbers, melon, strawberries, grapes and others.

Legumes are also useful foods - they contain many useful substances that reduce pressure on hemorrhoids during bowel movements and increase the softness of the stool after surgery.

An important component of the diet is water. It helps keep stool soft, prevent digestive problems and constipation, which can cause hemorrhoids to recur.

forbidden food

During the period rehabilitation after surgery to remove hemorrhoids prohibited:

• Fatty and fried foods.
• Carbonated drinks.
• Hot bread and other hot foods.
• Sweet pastries.
• Alcohol.
• Sauces, mustard.
• Tea coffee.
• Spicy dishes.

Physical exercise

In order to avoid the occurrence of a repeated hemorrhoid, patients are prohibited from lifting weights and any physical labor. That's whyrehabilitation after hemorrhoid surgerymust necessarily include a sparing lifestyle.

The only thing that is not forbidden to patients is to walk and do simple gymnastic exercises.

Duration of rehabilitation

Many patients are concerned about:how long does it take for a wound to heal after hemorrhoid surgery? The duration of the healing period depends on what type of surgery was used for treatment. If an open hemorrhoidectomy was used, the rehabilitation period can be about 6 weeks. When excised in a closed way, it will take about a month to recover.

Possible Complications

AT postoperative period after removal of hemorrhoidsit is necessary to strictly adhere to all the recommendations of the doctor. This will minimize the likelihood of complications and speed up the healing process.

The most common postoperative complications are:

• Bleeding. The cause of such a complication may be poorly sutured or cauterized blood vessels, as well as injury to postoperative wounds with hard feces.
• Painful sensations. Arise as a result of injury to the nerve endings located in the rectum.
• Infection. Occurs in case of non-compliance with personal hygiene or infection by health workers themselves.
• Urinary retention. This complication, as a rule, occurs in men and worries patients only for the first few hours after surgery.

correct treatment after hemorrhoid surgeryIt will help to avoid complications and speed up the recovery process, so that the patient will be able to return to his usual way of life sooner. After undergoing surgery, all patients are in dispensary treatment during the first year.