Anal fistula - Recovering from surgery

After having surgery to remove an anal fistula, you should be able to move around and eat and drink after the effects of the anaesthetic painkilling medication have worn off.

If the fistula is relatively simple to operate on, you may be able to go home on the same day as the surgery. However, if the fistula is complicated, you may need to stay in hospital for a few days or have further surgery to complete the procedure.

Looking after the wound

After the operation you will need to wear a dressing over the surgical cut until the wound has healed. Your dressings will need to be changed regularly and you will usually be shown how to do this at home. 

However, you may need to visit the hospital or GP surgery so they can check how the wound is healing or change the dressing for you. Most wounds take around six weeks to heal.

There may be some bleeding or a discharge from the wound for the first few weeks, particularly the first time you have a bath or go to the toilet.

You may wish to wear a pad, such as a sanitary towel, inside your underwear to avoid staining your clothes. This advice applies to both men and women.

You should see your GP if you have:

• heavy bleeding
• increasing pain, redness, swelling or discharge
• a high temperature of 38ºC (100.4ºF) or over
• nausea (feeling sick) or vomiting
• constipation ‐ being unable to empty your bowels for more than three days, despite using a laxative
• difficulty passing urine

Washing

The following tips may help keep the area around the fistula clean and prevent infection or irritation:

• use warm water and cotton wool to wash the skin, rather than a towel or sponge ‐ pat the skin dry rather than rubbing it, or use a hairdryer on a low setting
• avoid perfumed products and talcum powder as these can irritate the skin around the fistula
• you may be prescribed a barrier cream, which can be applied to stop irritants reaching the skin

Medication

Painkilling medication

After the anaesthetic has worn off, you may need to take some pain relief medication.

Over-the-counter painkillers such as paracetamol or ibuprofen can normally be used, although you should check with your surgeon before using them. Always read the manufacturer's instructions.

A 15-minute bath may also help reduce the pain. The bath water should be as warm as you can comfortably sit in.

Laxatives

Laxatives are a type of medicine that can help you empty your bowels. You may be prescribed laxatives to make it easier for you to go to the toilet after your operation.

Antibiotics

You may be prescribed antibiotics (medication to treat infections caused by bacteria) to take before and after surgery. These will help reduce the risk of an infection. If you are prescribed antibiotics, make sure you complete the course.

Resting

You may need rest for a few days after your operation, but you should avoid sitting still for a long time. Also avoid doing too much walking.

When you are resting, the following tips may help make you more comfortable:

• wear loose-fitting clothes and underwear
• lie on your side when on the sofa or in bed
• pillows or cushions may help make sitting more comfortable ‐ some pharmacies sell cushions designed to relieve pressure when sitting

Returning to normal activities

You can return to work and start to do some gentle exercise when you feel able to.

Ask your surgeon for advice on when you can drive again. This is usually after a minimum of 48 hours.

You should not go swimming until the wound has completely healed.