Anal Fistulotomy: What to Expect at Home
You had an anal fistulotomy. This surgery opens and drains an anal fistula and helps it heal.
You may be worried about having a bowel movement after your surgery. You will likely have some pain and bleeding with bowel movements for the first 1 to 2 weeks. You can make your bowel movements less painful by getting enough fibre and fluids, and using stool softeners or laxatives. Sitting in warm water (sitz bath) after bowel movements will also help.
You may notice a small amount of pus or blood draining from the opening of your fistula. This is normal in the days after your surgery. You can put a gauze pad over the opening of the fistula to absorb the drainage, if needed.
Most people can go back to work and their normal routine 1 to 2 weeks after surgery. It will probably take several weeks to several months for your fistula to completely heal. This depends on the size of your fistula and how much surgery you had.
This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.
How can you care for yourself at home?
- Rest when you feel tired. Getting enough sleep will help you recover.
- Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
- You may drive when you are no longer taking pain medicine and can quickly move your foot from the gas pedal to the brake. You must also be able to sit comfortably for a long period of time, even if you do not plan to go far. You might get caught in traffic.
- Most people are able to return to work within 1 to 2 weeks after surgery.
- Shower or take baths as usual. Pat your anal area dry with a towel when you are done.
- You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
- Drink plenty of fluids (unless your doctor tells you not to).
- Include high-fibre foods, such as fruits, vegetables, beans, and whole grains, in your diet each day.
- You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.
- Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
- If you take aspirin or some other blood thinner, ask your doctor if and when to start taking it again. Make sure that you understand exactly what your doctor wants you to do.
- Be safe with medicines. Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, take an over-the-counter medicine such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
- Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
- If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
- If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
- You may have gauze and bandages over the opening of your fistula, and you may have a string coming from the fistula called a seton drain. The seton drain can help relieve symptoms and mark the fistula for doctors to fix later. It may stay in place for 6 weeks or longer. Your doctor will tell you how to take care of your fistula after surgery.
- After a bowel movement, use a baby wipe or take a shower or sitz bath to gently clean the anal area.
- Place a maxi pad or gauze in your underwear to absorb drainage from your fistula while it heals.
- Sit in 8 to 10 centimetres of warm water (sitz bath) for 15 to 20 minutes. Then pat the area dry. Do this as long as you have pain in your anal area.
- Apply ice several times a day for 10 to 20 minutes at a time. Put a thin cloth between your skin and the ice.
- Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position. This can make bowel movements easier after surgery.
- Try lying on your stomach with a pillow under your hips to decrease swelling.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
When should you call for help?
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You are short of breath.
Call your doctor or nurse advice line now or seek immediate medical care if:
- You are sick to your stomach or cannot drink fluids.
- You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness and swelling in your leg or groin.
- You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
- You cannot pass stools or gas.
- Bright red blood has soaked through the bandage over your incision.
- You have pain that does not get better after you take pain medicine.
Watch closely for any changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.
Where can you learn more?
Go to https://www.healthwise.net/patientEd
Enter J352 in the search box to learn more about "Anal Fistulotomy: What to Expect at Home".
Adaptation Date: 2/28/2022
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services